| Name: | Blankenship General Surgery, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 14 Feb 2007 (18 years ago) |
| Entity Number: | 000-490-362 |
| Register Number: | 000490362 |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Principal Address: | MOBILE, AL |
| Registered Office Street Address: | 6701 AIRPORT BLVD STE B-316MOBILE, AL 36608 |
| Registered Office Street Address ZIP Code: | 36608 |
Activities
MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033239850 | 2007-03-29 | 2007-11-13 | 6701 AIRPORT BLVD, SUITE B-316, MOBILE, AL, 366086705, US | 6701 AIRPORT BLVD, SUITE B-316, MOBILE, AL, 366086705, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 251-634-2900 |
| Fax | 2516342626 |
Authorized person
| Name | DR. ALEXANDER LEE BLANKENSHIP |
| Role | OWNER |
| Phone | 2516342900 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| License Number | 17484 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS |
| Number | 51539462 |
| State | AL |
| Name | Role |
|---|---|
| BLANKENSHIP, ALEC | Agent |
| Name | Role |
|---|---|
| BLANKENSHIP, ALEC | Member |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
