| Name: | Adult and Pediatric Medicine, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 25 Feb 1991 (34 years ago) |
| Entity Number: | 000-141-731 |
| Register Number: | 000141731 |
| ZIP code: | 36117 |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Principal Address: | MONTGOMERY, AL |
| Registered Office Street Address: | 105 NATCHEZ COURTMONTGOMERY, AL 36117 |
| Authorized Capital: | $100,000 |
Activities
ANY LAWFUL ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073548004 | 2006-07-11 | 2011-07-01 | 4825 VIRGINIA LOOP RD, MONTGOMERY, AL, 36116, US | 4825 VIRGINIA LOOP RD, MONTGOMERY, AL, 36116, US | |||||||||||||||||||||||||
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| Phone | +1 334-286-9772 |
| Fax | 3342849828 |
Authorized person
| Name | DR. LEATHA BARBER MORGAN |
| Role | VICE PRESIDENT |
| Phone | 3342849772 |
Taxonomy
| Taxonomy Code | 207QA0505X - Adult Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000083670 |
| State | AL |
| Name | Role |
|---|---|
| MORGAN, THEODORE MCKINLEY SR MD | Incorporator |
| Name | Role |
|---|---|
| MORGAN, THEODORE MCKINLEY SR MD | Agent |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
