| Name: | Chilton Medical Group, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 13 Apr 2000 (25 years ago) |
| Entity Number: | 000-209-300 |
| Register Number: | 000209300 |
| ZIP code: | 35209 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | BIRMINGHAM, AL |
| Registered Office Street Address: | 2000 SOUTHBRIDGE PKWY STE 500BIRMINGHAM, AL 35209 |
| Authorized Capital: | $1,000 |
Activities
PRACTICE FAMILY MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629121553 | 2007-01-22 | 2024-03-28 | 108 MEDICAL CENTER DR, CLANTON, AL, 350452332, US | 108 MEDICAL CENTER DR, CLANTON, AL, 350452332, US | |||||||||||||||||
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| Phone | +1 205-755-5700 |
| Fax | 2057554966 |
| Fax | 8884187660 |
Authorized person
| Name | HEATHER RENEE GANN |
| Role | ADMINISTRATOR |
| Phone | 2057555700 |
Taxonomy
| Taxonomy Code | 173000000X - Legal Medicine |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WERTHEIMER, LEONARD III | Agent | 2001 PARK PLACE NORTH STE 700BIRMINGHAM, AL 35203-4804 |
| Name | Role | Address |
|---|---|---|
| KINGREN, J FRED | Incorporator | 1801 FIFTH AVE N STE 400BIRMINGHAM, AL 35203 |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
