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Selma Surgical Associates, LLC

Details

Name: Selma Surgical Associates, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Dissolved
Date of registration: 14 Jun 2007 (17 years ago) (Companies founded in June 2007)
Date of dissolution: 15 May 2017
Entity Number: 000-495-894
Register Number: 000495894
ZIP code: 36104 (Companies in Montgomery, 36104)
County: Montgomery
Place of Formation: Montgomery County
Principal Address: MONTGOMERY, AL
Registered Office Street Address: 2 NORTH JACKSON ST., SUITE 605MONTGOMERY, AL 36104

Activities MEDICAL PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1578743449 2007-11-08 2008-05-30 200 VAUGHAN MEMORIAL DR, SELMA, AL, 367016508, US 200 VAUGHAN MEMORIAL DR, SELMA, AL, 367016508, US

Contacts

Phone +1 334-872-0111
Fax 3348720136

Authorized person

Name DR. JOHN A. INDOVINA JR.
Role OWNER
Phone 3348720111

Taxonomy

Taxonomy Code 174400000X - Specialist
License Number MD28281
State AL
Is Primary Yes

Agent

Name Role Address
C T CORPORATION SYSTEM Agent 2 NORHT JACKSON STREET SUITE 605MONTGOMERY, AL 36104

Member

Name Role
INDOVINA, JOHN Member

Date of last update: 14 Aug 2024

Sources: Alabama Secretary of State