| Name: | FBL Physicians, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 27 Apr 2023 (2 years ago) |
| Entity Number: | 001-076-476 |
| Register Number: | 001076476 |
| County: | Mobile |
| Place of Formation: | Alabama |
| Principal Address: | 507 Saint Francis StreetMobile, AL 36602 |
| Principal Address ZIP Code: | 36602 |
| Authorized Capital: | 500 |
| Paid Share Capital: | 1.00 |
Activities
To engage in any lawful business
act or activity for which a Corporation may be organized.
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780468108 | 2023-08-24 | 2024-09-04 | 171 MOBILE INFIRMARY BLVD, MOBILE, AL, 366073509, US | 171 MOBILE INFIRMARY BLVD, MOBILE, AL, 366073509, US | |||||||||||||||||
|
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| Phone | +1 251-300-9223 |
Authorized person
| Name | SHARON BUSH-COAXUM |
| Role | PARTNER |
| Phone | 2513009223 |
Taxonomy
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| Is Primary | Yes |
| Taxonomy Code | 207VG0400X - Gynecology Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| Surface, Mitchell J | Incorporator | 1901 Sixth Avenue NorthBirmingham, AL 35203 |
| Name | Role |
|---|---|
| Smith, Royshanda | Agent |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
