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  5. Surgical Associates, P.C.

Surgical Associates, P.C.

Details

Name: Surgical Associates, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 27 Mar 1969 (56 years ago)
Entity Number: 000-019-374
Register Number: 000019374
Historical Names: Viar-Donald, P.A.
Donald-Peacock, P.A.
Surgical Associates, P.A.
ZIP code: 35205
County: Jefferson
Place of Formation: Jefferson County
Principal Address: BIRMINGHAM, AL
Registered Office Street Address: 806 ST. VINCENT'S DRIVE SUITE 500BIRMINGHAM, AL 35205
Authorized Capital: $10,000
Paid Share Capital: $5,000

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1518140219 2007-12-17 2009-03-17 513 BROOKWOOD BLVD, SUITE 501, BIRMINGHAM, AL, 352096862, US 2700 10TH AVE S, SUITE 510, BIRMINGHAM, AL, 352051200, US

Contacts
Phone +1 205-930-8010
Fax 2059308014

Authorized person
Name JERRY L KITCHENS JR.
Role PRESIDENT
Phone 2059308010

Taxonomy
Taxonomy Code 208600000X - Surgery Physician
License Number 16460
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SURGICAL ASSOCIATES, P.C. 401(K) PROFIT SHARING RETIREMENT PLAN 2019 630574926 2020-07-26 SURGICAL ASSOCIATES, P.C. 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1969-08-01
Business code 621111
Sponsor’s telephone number 2059308010
Plan sponsor’s address 2022 BROOKWOOD MEDICAL CENTER DRIVE, SUITE 207, BIRMINGHAM, AL, 35209

Signature of
Role Plan administrator
Date 2020-07-26
Name of individual signing TIMOTHY BULLOCK
SURGICAL ASSOCIATES, P.C. 401(K) PROFIT SHARING RETIREMENT PLAN 2018 630574926 2019-07-29 SURGICAL ASSOCIATES, P.C. 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1969-08-01
Business code 621111
Sponsor’s telephone number 2059308010
Plan sponsor’s address 2022 BROOKWOOD MEDICAL CENTER DRIVE, SUITE 207, BIRMINGHAM, AL, 35209

Signature of
Role Plan administrator
Date 2019-07-29
Name of individual signing TIMOTHY BULLOCK
SURGICAL ASSOCIATES, P.C. 401(K) PROFIT SHARING RETIREMENT PLAN 2017 630574926 2018-07-12 SURGICAL ASSOCIATES, P.C. 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1969-08-01
Business code 621111
Sponsor’s telephone number 2057762120
Plan sponsor’s address 513 BROOKWOOD BOULEVARD, SUITE 501, BIRMINGHAM, AL, 35209
SURGICAL ASSOCIATES, P.C. 401(K) PROFIT SHARING RETIREMENT PLAN 2016 630574926 2017-07-28 SURGICAL ASSOCIATES, P.C. 19
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1969-08-01
Business code 621111
Sponsor’s telephone number 2057762120
Plan sponsor’s address 513 BROOKWOOD BOULEVARD, SUITE 501, BIRMINGHAM, AL, 35209
SURGICAL ASSOCIATES, P.C. 401(K) PROFIT SHARING RETIREMENT PLAN 2015 630574926 2016-10-13 SURGICAL ASSOCIATES, P.C. 19
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1969-08-01
Business code 621111
Sponsor’s telephone number 2057762120
Plan sponsor’s address 513 BROOKWOOD BOULEVARD, SUITE 501, BIRMINGHAM, AL, 35209
SURGICAL ASSOCIATES, P.C. 401(K) PROFIT SHARING RETIREMENT PLAN 2014 630574926 2015-07-13 SURGICAL ASSOCIATES, P.C. 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1969-08-01
Business code 621111
Sponsor’s telephone number 2057762120
Plan sponsor’s address 513 BROOKWOOD BOULEVARD, SUITE 501, BIRMINGHAM, AL, 35209

Signature of
Role Plan administrator
Date 2015-07-13
Name of individual signing TIMOTHY K. BULLOCK
Role Employer/plan sponsor
Date 2015-07-13
Name of individual signing TIMOTHY K. BULLOCK
SURGICAL ASSOCIATES, P.C. 401(K) PROFIT SHARING RETIREMENT PLAN 2013 630574926 2014-10-08 SURGICAL ASSOCIATES, P.C. 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1969-08-01
Business code 621111
Sponsor’s telephone number 2057762120
Plan sponsor’s address 513 BROOKWOOD BOULEVARD, SUITE 501, BIRMINGHAM, AL, 35209

Signature of
Role Plan administrator
Date 2014-10-08
Name of individual signing TIMOTHY K. BULLOCK, M.D.
Role Employer/plan sponsor
Date 2014-10-08
Name of individual signing TIMOTHY K. BULLOCK, M.D.
SURGICAL ASSOCIATES, P.C. 401(K) PROFIT SHARING RETIREMENT PLAN 2012 630574926 2013-07-29 SURGICAL ASSOCIATES, P.C. 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1969-08-01
Business code 621111
Sponsor’s telephone number 2059308010
Plan sponsor’s address 513 BROOKWOOD BOULEVARD, SUITE 501, BIRMINGHAM, AL, 35209

Signature of
Role Plan administrator
Date 2013-07-29
Name of individual signing RICHARD I KIRKLAND
Role Employer/plan sponsor
Date 2013-07-29
Name of individual signing RICHARD I KIRKLAND
SURGICAL ASSOCIATES, P.C. 401(K) PROFIT SHARING RETIREMENT PLAN 2011 630574926 2013-03-25 SURGICAL ASSOCIATES, P.C. 19
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1969-08-01
Business code 621111
Sponsor’s telephone number 2059308010
Plan sponsor’s address 513 BROOKWOOD BOULEVARD, SUITE 501, BIRMINGHAM, AL, 35209

Plan administrator’s name and address
Administrator’s EIN 630574926
Plan administrator’s name SURGICAL ASSOCIATES, P.C.
Plan administrator’s address 513 BROOKWOOD BOULEVARD, SUITE 501, BIRMINGHAM, AL, 35209
Administrator’s telephone number 2059308010

Signature of
Role Plan administrator
Date 2013-03-25
Name of individual signing RICHARD KIRKLAND
Role Employer/plan sponsor
Date 2013-03-25
Name of individual signing RICHARD KIRKLAND

Incorporator

Name Role
DONALD, JOSEPH M JR DR Incorporator
VIAR, WILLIAM DR Incorporator

Agent

Name Role
BULLOCK, TIMOTHY K Agent

Events

Event Date Event Type Old Value New Value
1984-01-03 Name Change Surgical Associates, P.A. Surgical Associates, P.C.
1977-09-01 Name Change Donald-Peacock, P.A. Surgical Associates, P.A.
1971-11-29 Name Change Viar-Donald, P.A. Donald-Peacock, P.A.

Related by officers

No related officers

Related by address

BIRMINGHAM, AL

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Date of last update: 30 Jul 2024

Sources: Alabama Secretary of State

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