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Auburn Orthopaedic Center, P.C.

Details

Name: Auburn Orthopaedic Center, P.C.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Dissolved
Date of registration: 30 Oct 1990 (34 years ago)
Date of dissolution: 31 Dec 2013
Entity Number: 000-139-860
Register Number: 000139860
ZIP code: 36830
County: Lee
Place of Formation: Lee County
Principal Address: AUBURN, AL
Registered Office Street Address: 459 N DEAN RDAUBURN, AL 36830
Authorized Capital: $100

Activities PRACTICE ORTHOPAEDIC MEDICINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1669419081 2006-06-02 2010-06-22 1800 LAKESIDE CIR, AUBURN, AL, 368302842, US 1800 LAKESIDE CIR, AUBURN, AL, 368302842, US

Contacts

Phone +1 334-826-9800
Fax 3348263441

Authorized person

Name MR. BILLY L NEW
Role ADMINISTRATOR
Phone 3348269800

Taxonomy

Taxonomy Code 207X00000X - Orthopaedic Surgery Physician
License Number 5629
State AL
Is Primary Yes

Other Provider Identifiers

Issuer US DEPT LABOR W/C ID
Number 167540200
State AL
Issuer RRMC
Number CL8760
State AL
Issuer BCBS
Number 510 82830
State AL
Issuer MEDICAID
Number 000082830
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PROFIT SHARING PLAN OF AUBURN ORTHOPAEDIC CENTER, P.C. 2013 631031649 2014-02-05 AUBURN ORTHOPAEDIC CENTER, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-06-01
Business code 621111
Sponsor’s telephone number 3348269800
Plan sponsor’s address 1800 LAKESIDE CIRCLE, AUBURN, AL, 36830

Signature of

Role Plan administrator
Date 2014-02-05
Name of individual signing RAYMOND GODSIL
AUBURN ORTHOPAEDIC CENTER, P.C. 2012 631031649 2013-07-17 AUBURN ORTHOPAEDIC CENTER, P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-06-01
Business code 621111
Sponsor’s telephone number 3348269800
Plan sponsor’s address 1800 LAKESIDE CIRCLE, AUBURN, AL, 36830

Signature of

Role Plan administrator
Date 2013-07-17
Name of individual signing RAYMOND GODSIL
PROFIT SHARING PLAN OF AUBURN ORTHOPAEDIC CENTER, P.C. 2011 631031649 2012-07-18 AUBURN ORTHOPAEDIC CENTER, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-06-01
Business code 621111
Sponsor’s telephone number 3348269800
Plan sponsor’s address 1800 LAKESIDE CIRCLE, AUBURN, AL, 36830

Plan administrator’s name and address

Administrator’s EIN 631031649
Plan administrator’s name AUBURN ORTHOPAEDIC CENTER, P.C.
Plan administrator’s address 1800 LAKESIDE CIRCLE, AUBURN, AL, 36830
Administrator’s telephone number 3348269800

Signature of

Role Plan administrator
Date 2012-07-18
Name of individual signing BILLY L. NEW
PROFIT SHARING PLAN OF AUBURN ORTHOPAEDIC CENTER, P.C. 2010 631031649 2011-06-14 AUBURN ORTHOPAEDIC CENTER, P.C. 6
Three-digit plan number (PN) 001
Effective date of plan 1991-06-01
Business code 621111
Sponsor’s telephone number 3378269800
Plan sponsor’s address 1800 LAKESIDE CIRCLE, AUBURN, AL, 36830

Plan administrator’s name and address

Administrator’s EIN 631031649
Plan administrator’s name AUBURN ORTHOPAEDIC CENTER, P.C.
Plan administrator’s address 1800 LAKESIDE CIRCLE, AUBURN, AL, 36830
Administrator’s telephone number 3378269800

Signature of

Role Plan administrator
Date 2011-06-14
Name of individual signing BILLY L NEW
PROFIT SHARING PLAN OF AUBURN ORTHOPAEDIC CENTER, P.C. 2010 631031649 2011-10-31 AUBURN ORTHOPAEDIC CENTER, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-06-01
Business code 621111
Sponsor’s telephone number 3378269800
Plan sponsor’s address 1800 LAKESIDE CIRCLE, AUBURN, AL, 36830

Plan administrator’s name and address

Administrator’s EIN 631031649
Plan administrator’s name AUBURN ORTHOPAEDIC CENTER, P.C.
Plan administrator’s address 1800 LAKESIDE CIRCLE, AUBURN, AL, 36830
Administrator’s telephone number 3378269800

Signature of

Role Plan administrator
Date 2011-10-31
Name of individual signing BILLY L. NEW
PROFIT SHARING PLAN OF AUBURN ORTHOPAEDIC CENTER, P.C. 2009 631031649 2010-08-24 AUBURN ORTHOPAEDIC CENTER, P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-06-01
Business code 621111
Sponsor’s telephone number 3348269800
Plan sponsor’s address 1800 LAKESIDE CIRCLE, AUBURN, AL, 36830

Plan administrator’s name and address

Administrator’s EIN 631031649
Plan administrator’s name AUBURN ORTHOPAEDIC CENTER, P.C.
Plan administrator’s address 1800 LAKESIDE CIRCLE, AUBURN, AL, 36830
Administrator’s telephone number 3348269800

Signature of

Role Plan administrator
Date 2010-08-24
Name of individual signing BILLY L. NEW

Agent

Name Role Address
GODSIL, RAYMOND D JR Agent 700 WRIGHTS MILL ROADAUBURN, AL 36830

Incorporator

Name Role Address
GODSIL, RAYMOND D JR Incorporator 700 WRIGHTS MILL ROADAUBURN, AL 36830

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State