| Name: | Schaffer Plastic Surgery, P C |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 20 Jun 2016 (8 years ago) |
| Entity Number: | 000-365-756 |
| Register Number: | 000365756 |
| County: | Jefferson |
| Place of Formation: | Shelby County |
| Principal Address: | 3595 GRANDVIEW PKWYBIRMINGHAM, AL 35243 |
| Principal Address ZIP Code: | 35243 |
| Principal Mailing Address: | 5008 GREYSTONE WAYBIRMINGHAM, AL 35242 |
| Principal Mailing Address ZIP Code: | 35242 |
| Authorized Capital: | 100 |
Activities
MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003326497 | 2017-10-11 | 2017-10-11 | 3595 GRANDVIEW PKWY STE 150, BIRMINGHAM, AL, 352431935, US | 3595 GRANDVIEW PKWY STE 150, BIRMINGHAM, AL, 352431935, US | |||||||||||||||||||||||||||
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| Phone | +1 205-278-7969 |
| Fax | 2053972101 |
Authorized person
| Name | DR. CHRISTOPHER JON SCHAFFER |
| Role | OWNER |
| Phone | 2052787969 |
Taxonomy
| Taxonomy Code | 208200000X - Plastic Surgery Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PTAN NUMBER |
| Number | 102I241110 |
| State | AL |
| Issuer | BLUE CROSS BLUE SHIELD OF ALABAMA |
| Number | 51106702 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| SCHAFFER, CHRISTOPHER J | Director | 5008 GREYSTONE WAYBIRMINGHAM, AL 35242 |
| Name | Role | Address |
|---|---|---|
| SCHAFFER, CHRISTOPHER J | Agent | 5008 GREYSTONE WAYBIRMINGHAM, AL 35242 |
| Name | Role | Address |
|---|---|---|
| SCHAFFER, CHRISTOPHER J | Incorporator | 5008 GREYSTONE WAYBIRMINGHAM, AL 35242 |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
