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Clarke County Family Medicine, LLC

Details

Name: Clarke County Family Medicine, LLC
Jurisdiction: Alabama
Legal type: Foreign Limited Liability Company
Status: Exists
Date of registration: 07 Jan 2007 (18 years ago)
Entity Number: 000-612-139
Register Number: 000612139
County: Clarke
Place of Formation: Georgia
Principal Address: 33700 HWY 43THOMASVILLE, AL 36784
Principal Address ZIP Code: 36784

Activities HOSPITAL & HEALTHCARE SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1912156878 2008-09-16 2008-10-16 33650 HIGHWAY 43 STE 100, THOMASVILLE, AL, 367843307, US 33650 HIGHWAY 43 STE 100, THOMASVILLE, AL, 367843307, US

Contacts

Phone +1 334-636-0791
Fax 3346360602

Authorized person

Name LISA SIMS
Role COO
Phone 3346364431

Taxonomy

Taxonomy Code 207Q00000X - Family Medicine Physician
Is Primary Yes

Agent

Name Role
SIMS, LISA Agent

Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State