| Name: | Dr. Ty Ashley, M.D., LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Series Limited Liability Company |
| Status: | Exists |
| Date of registration: | 27 Aug 2015 (9 years ago) |
| Entity Number: | 000-343-496 |
| Register Number: | 000343496 |
| County: | Lauderdale |
| Place of Formation: | Lauderdale County |
| Registered Office Street Address: | 727 COX CREEK PARKWAYFLORENCE, AL 35630 |
| Registered Office Street Address ZIP Code: | 35630 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972970358 | 2015-09-01 | 2015-09-01 | 727 COX CREEK PKWY, FLORENCE, AL, 356301001, US | 727 COX CREEK PKWY, FLORENCE, AL, 356301001, US | |||||||||||||||||||
|
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| Phone | +1 256-764-9613 |
| Fax | 2567649138 |
Authorized person
| Name | DR. TIMOTHY DALE ASHLEY JR. |
| Role | PHYSICIAN |
| Phone | 2567649613 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 34205 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| ASHLEY, TIMOTHY D JR | Agent |
| Name | Role | Address |
|---|---|---|
| BURCHELL, ADAM B | Organizer | 1847 NORTH WOOD AVENUEFLORENCE, AL 35630 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
