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Auburn Gastroenterology, LLC

Details

Name: Auburn Gastroenterology, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 08 Jun 2015 (9 years ago)
Entity Number: 000-337-588
Register Number: 000337588
County: Lee
Place of Formation: Lee County
Registered Office Street Address: 1831 FAIRWAY DRIVEAUBURN, AL 36830
Registered Office Street Address ZIP Code: 36830

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1497135347 2015-06-05 2023-08-14 785 N DEAN RD STE 400, AUBURN, AL, 368304034, US 835 N DEAN RD STE A, AUBURN, AL, 368304034, US

Contacts

Phone +1 334-329-7822
Fax 8886671168

Authorized person

Name BRICE JONES
Role MANAGER
Phone 3343297822

Taxonomy

Taxonomy Code 207RG0100X - Gastroenterology Physician
License Number 19629
State AL
Is Primary No
Taxonomy Code 208600000X - Surgery Physician
License Number 19629
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AUBURN GASTROENTEROLOGY PROFIT SHARING PLAN 2023 474167681 2024-09-24 AUBURN GASTROENTEROLOGY 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 3343297822
Plan sponsor’s address 835 NORTH DEAN ROAD, SUITE A, AUBURN, AL, 36830

Signature of

Role Plan administrator
Date 2024-09-24
Name of individual signing WILLIAM ADKINS, MD
Valid signature Filed with authorized/valid electronic signature
AUBURN GASTROENTEROLOGY PROFIT SHARING PLAN 2022 474167681 2023-10-16 AUBURN GASTROENTEROLOGY 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 3343297822
Plan sponsor’s address 785 NORTH DEAN ROAD, SUITE 400, AUBURN, AL, 36830

Signature of

Role Plan administrator
Date 2023-10-16
Name of individual signing WILLIAM ADKINS, MD
AUBURN GASTROENTEROLOGY PROFIT SHARING PLAN 2021 474167681 2022-10-06 AUBURN GASTROENTEROLOGY 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 3343297822
Plan sponsor’s address 785 NORTH DEAN ROAD, SUITE 400, AUBURN, AL, 36830

Signature of

Role Plan administrator
Date 2022-10-06
Name of individual signing WILLIAM ADKINS, MD
AUBURN GASTROENTEROLOGY PROFIT SHARING PLAN 2020 474167681 2021-07-29 AUBURN GASTROENTEROLOGY 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 3343297822
Plan sponsor’s address 785 NORTH DEAN ROAD, SUITE 400, AUBURN, AL, 36830

Signature of

Role Plan administrator
Date 2021-07-29
Name of individual signing WILLIAM ADKINS, MD
AUBURN GASTROENTEROLOGY PROFIT SHARING PLAN 2019 474167681 2020-10-13 AUBURN GASTROENTEROLOGY 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 3343297822
Plan sponsor’s address 785 NORTH DEAN ROAD, SUITE 400, AUBURN, AL, 36830

Signature of

Role Plan administrator
Date 2020-10-13
Name of individual signing WILLIAM ADKINS, MD
AUBURN GASTROENTEROLOGY PROFIT SHARING PLAN 2018 474167681 2019-10-15 AUBURN GASTROENTEROLOGY 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 3343297822
Plan sponsor’s address 785 NORTH DEAN ROAD, SUITE 400, AUBURN, AL, 36830

Signature of

Role Plan administrator
Date 2019-10-15
Name of individual signing WILLIAM ADKINS, MD
AUBURN GASTROENTEROLOGY PROFIT SHARING PLAN 2017 474167681 2018-07-24 AUBURN GASTROENTEROLOGY 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 3343297822
Plan sponsor’s address 785 NORTH DEAN ROAD, SUITE 400, AUBURN, AL, 36830

Signature of

Role Plan administrator
Date 2018-07-24
Name of individual signing WILLIAM ADKINS, MD
AUBURN GASTROENTEROLOGY PROFIT SHARING PLAN 2016 474167681 2017-07-22 AUBURN GASTROENTEROLOGY 0
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 3343297822
Plan sponsor’s address 785 NORTH DEAN ROAD, SUITE 400, AUBURN, AL, 36830

Signature of

Role Plan administrator
Date 2017-07-22
Name of individual signing WILLIAM ADKINS, MD

Organizer

Name Role Address
WHITE, R BRIAN Organizer 2705 ARTIE STREET BLDG 500 SUITE 33HUNTSVILLE, AL 35805

Agent

Name Role
ADKINS, W K Agent

Date of last update: 03 Aug 2024

Sources: Alabama Secretary of State