| Name: | Spedale MD, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 12 Feb 2019 (6 years ago) |
| Entity Number: | 000-542-866 |
| Register Number: | 000542866 |
| County: | Houston |
| Place of Formation: | Houston County |
| Registered Office Street Address: | 408 MONTEZUMA AVEDOTHAN, AL 36303 |
| Registered Office Street Address ZIP Code: | 36303 |
| Authorized Capital: | 1000 @ $1.00 PV |
Activities
PERFORM PROFESSIONAL SERVICES
MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184273096 | 2019-09-04 | 2020-11-06 | 3113 WESLEY WAY STE 1, DOTHAN, AL, 363052004, US | 3113 WESLEY WAY STE 1, DOTHAN, AL, 363052004, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 334-699-5123 |
| Fax | 3346995125 |
Authorized person
| Name | DR. ANTHONY ROLAND SPEDALE JR. |
| Role | PHYSICIAN |
| Phone | 3346995123 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SPEDALE, ANTHONY R JR | Agent | 408 MONTEZUMA AVEDOTHAN, AL 36303 |
| Name | Role | Address |
|---|---|---|
| SPEDALE, ANTHONY R JR | Director | 408 MONTEZUMA AVEDOTHAN, AL 36303 |
| Name | Role | Address |
|---|---|---|
| SPEDALE, ANTHONY R JR | Incorporator | 408 MONTEZUMA AVEDOTHAN, AL 36303 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
