| Name: | Alabama Eye Physicians and Surgeons, P.C., Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 02 Jan 2015 (10 years ago) |
| Entity Number: | 000-325-392 |
| Register Number: | 000325392 |
| County: | Houston |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 5937 W MAIN STDOTHAN, AL 36305 |
| Registered Office Street Address ZIP Code: | 36305 |
| Authorized Capital: | 1 |
Activities
MEDICAL DOCTOR
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ZABHEMV47BX5 | 2024-06-28 | 5937 W MAIN ST, DOTHAN, AL, 36305, 9317, USA | 5937 W MAIN ST, DOTHAN, AL, 36305, 9317, USA | |||||||||||||||||||||||||||||||||||
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| Congressional District | 02 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2023-07-03 |
| Initial Registration Date | 2023-06-29 |
| Entity Start Date | 2015-05-15 |
| Fiscal Year End Close Date | Dec 31 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | PENNY MOSS |
| Address | 5937 W MAIN ST, DOTHAN, AL, 36305, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | PENNY MOSS |
| Address | 5937 W MAIN ST, DOTHAN, AL, 36305, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174914881 | 2015-02-17 | 2015-06-26 | 5937 W MAIN ST, DOTHAN, AL, 363059317, US | 5937 W MAIN ST, DOTHAN, AL, 363059317, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 334-446-0872 |
| Fax | 3344460893 |
Authorized person
| Name | DR. KIRK STURRIDGE |
| Role | PRESIDENT |
| Phone | 3344460872 |
Taxonomy
| Taxonomy Code | 207W00000X - Ophthalmology Physician |
| License Number | MD.30046 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 002006500 |
| State | FL |
| Issuer | MEDICAID |
| Number | 80637829A |
| State | GA |
| Issuer | MEDICAID |
| Number | 117610 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| STURRIDGE, KIRK | Agent | 101 EDINBURGH WAYDOTHAN, AL 36305 |
| Name | Role | Address |
|---|---|---|
| STURRIDGE, KIRK | Director | 101 EDINBURGH WAYDOTHAN, AL 36305 |
| Name | Role | Address |
|---|---|---|
| MOSELEY, CHEYENNE | Incorporator | 9900 SPECTRUM DRIVEAUSTIN, TX 78717 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
