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Dr. Dale Mitchum, Inc.

Headquarter

Details

Name: Dr. Dale Mitchum, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Exists
Date of registration: 14 Jan 2005 (20 years ago)
Entity Number: 000-239-186
Register Number: 000239186
ZIP code: 36340
County: Geneva
Place of Formation: Geneva County
Principal Address: GENEVA, AL
Registered Office Street Address: 2 W LAKE LAKE PROFESSIONAL PKGENEVA, AL 36340
Authorized Capital: $10,000

Activities PRACTICE MEDICINE

Links between entities

Type Company Name Company Number State
Headquarter of Dr. Dale Mitchum, Inc., FLORIDA F08000000540 FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1407299894 2013-04-16 2013-04-16 PO BOX 900, GENEVA, AL, 363400900, US 100 W LAKE PROFESSIONAL PARK STE 2, GENEVA, GENEVA, AL, 363401200, US

Contacts

Phone +1 334-684-3007
Fax 3346843059

Authorized person

Name DR. DALE G MITCHUM
Role OWNER
Phone 3346843007

Taxonomy

Taxonomy Code 207Q00000X - Family Medicine Physician
License Number 12381
State AL
Is Primary No
Taxonomy Code 208600000X - Surgery Physician
Is Primary Yes

Agent

Name Role
MITCHUM, DALE Agent

Incorporator

Name Role
MITCHUM, DALE Incorporator

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State