| Name: | Southside Endocrinology, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 12 May 2006 (19 years ago) (Companies founded in May 2006) |
| Entity Number: | 000-478-938 |
| Register Number: | 000478938 |
| ZIP code: | 35205 (Companies in Jefferson, 35205) |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | BIRMINGHAM, AL |
| Registered Office Street Address: | 1020 20TH ST SOUTHBIRMINGHAM, AL 35205 |
Activities
REAL/PERSONAL PROPERTY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528119781 | 2007-01-15 | 2016-08-31 | 1900 CRESTWOOD BLVD, STE 201, IRONDALE, AL, 352102051, US | 1900 CRESTWOOD BLVD, STE 201, IRONDALE, AL, 352102051, US | |||||||||||||||||||||||||
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| Phone | +1 205-957-0034 |
| Fax | 2059570036 |
Authorized person
| Name | DR. DAVID SAMUEL HENRY BELL |
| Role | PRESIDENT |
| Phone | 2059570034 |
Taxonomy
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| License Number | 9301 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE PTAN |
| Number | L192 |
| State | AL |
| Name | Role |
|---|---|
| BELL, DAVID S H | Agent |
| Name | Role |
|---|---|
| BELL, DAVID S H | Member |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
