| Name: | IMC-North Baldwin Physician Group, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 04 May 2016 (9 years ago) (Companies founded in May 2016) |
| Entity Number: | 000-362-952 |
| Register Number: | 000362952 |
| Historical Names: |
IMC-North Baldwin Physician Group, P.C.
|
| ZIP code: | 36604 (Companies in Mobile, 36604) |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Registered Office Street Address: | 5 MOBILE INFIRMARY CIRCLEMOBILE, AL 36607 |
| Principal Address: | 1700 SPRINGHILL AVENUEMOBILE, AL 36604 |
| Principal Mailing Address: | PO BOX 2226MOBILE, AL 36652 |
Activities
TO RENDER PROFESSIONAL MEDICAL SVCS & SERVICES ANCILLARY THERETO
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619473766 | 2018-04-05 | 2021-02-03 | 2002 MEDICAL CENTER DR, BAY MINETTE, AL, 365074163, US | 2002 MEDICAL CENTER DR, BAY MINETTE, AL, 365074163, US | |||||||||||||||||
|
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| Phone | +1 251-435-1331 |
Authorized person
| Name | MR. ANTHONY PALAZZO |
| Role | VICE PRESIDENT OF FINANCE |
| Phone | 2514351331 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| NIX, D.MARK | Agent |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2017-03-24 | Name Change | IMC-North Baldwin Physician Group, P.C. | IMC-North Baldwin Physician Group, LLC |
Date of last update: 04 Aug 2024
Sources: Alabama Secretary of State
