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Vascular and Interventional Specialists of Alabama, PLLC

Details

Name: Vascular and Interventional Specialists of Alabama, PLLC
Jurisdiction: Alabama
Legal type: Domestic Professional Limited Liability Company
Status: Exists
Date of registration: 03 Apr 2024 (8 months ago) (Companies founded in April 2024)
Entity Number: 001-129-654
Register Number: 001129654
ZIP code: 36104 (Companies in Montgomery, 36104)
County: Montgomery
Place of Formation: Alabama
Registered Office Street Address: 2 NORTH JACKSON STREET, SUITE 605MONTGOMERY, AL 36104

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1073345724 2024-08-19 2024-08-19 6800 ELAINA LN, TUSCALOOSA, AL, 354063211, US 120 CAHABA VALLEY PKWY STE 200, PELHAM, AL, 351241179, US

Contacts

Phone +1 205-907-2757

Authorized person

Name DR. LOUIS WILLIAM LUCAS
Role PHYSICIAN/OWNER
Phone 2059072757

Taxonomy

Taxonomy Code 2085R0202X - Diagnostic Radiology Physician
Is Primary No
Taxonomy Code 2085R0204X - Vascular & Interventional Radiology Physician
Is Primary Yes

Agent

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

Date of last update: 18 Aug 2024

Sources: Alabama Secretary of State