| Name: | Bullock Preventive and Family Medicine LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 26 Aug 2014 (10 years ago) |
| Entity Number: | 000-316-916 |
| Register Number: | 000316916 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | 430 EMERY DRIVEHOOVER, AL 35244 |
| Principal Address ZIP Code: | 35244 |
| Registered Office Street Address: | 1280 COLUMBIANA ROAD SUITE 120BIRMINGHAM, AL 35216 |
| Registered Office Street Address ZIP Code: | 35216 |
Activities
PRACTICE OF MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912300641 | 2014-10-08 | 2015-10-02 | 430 EMERY DR, SUITE 700, HOOVER, AL, 352444587, US | 430 EMERY DR, SUITE 700, HOOVER, AL, 352444587, US | |||||||||||||||||
|
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| Phone | +1 205-987-4044 |
Authorized person
| Name | GARY BULLOCK |
| Role | MANAGING MEMBER |
| Phone | 2059874044 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | DO729 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| OLIVER, REA | Agent | 4072 MILNERS CRESCENTBIRMINGHAM, AL 35242 |
| Name | Role | Address |
|---|---|---|
| BULLOCK, GARY | Organizer | 430 EMERY DRIVEHOOVER, AL 35244 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
