| Name: | North Alabama Podiatry, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 03 Jan 2008 (17 years ago) |
| Entity Number: | 000-414-299 |
| Register Number: | 000414299 |
| County: | Colbert |
| Place of Formation: | Colbert County |
| Principal Address: | TUSCUMBIA, AL |
| Registered Office Street Address: | 1404 EAST AVALON AVE STE C-2TUSCUMBIA, AL 35674 |
| Registered Office Street Address ZIP Code: | 35674 |
Activities
PROFESSIONAL PODIATRY SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891961678 | 2008-05-01 | 2015-01-30 | PO BOX 2583, MUSCLE SHOALS, AL, 356622583, US | 2200A 2ND ST, MUSCLE SHOALS, AL, 356611271, US | |||||||||||||||||||||||||
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| Phone | +1 256-381-3878 |
| Fax | 2563816040 |
Authorized person
| Name | DR. MICHAEL R LINVILLE |
| Role | DOCTOR/SOLE MBR |
| Phone | 2563813878 |
Taxonomy
| Taxonomy Code | 213ES0131X - Foot Surgery Podiatrist |
| License Number | 0259 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD OF ALABAMA |
| Number | 510-10708 |
| State | AL |
| Name | Role |
|---|---|
| LINVILLE, MICHAEL | Agent |
| Name | Role |
|---|---|
| LINVILLE, MICHAEL | Member |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
