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JEFFREY B. RICHARDSON, M.D., P.S.C.

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Company Details

Name: JEFFREY B. RICHARDSON, M.D., P.S.C.
Legal type: Kentucky Professional Services Corp
Status: Inactive
Standing: Good
Profit or Non-Profit: Profit
File Date: 02 Nov 1995 (30 years ago)
Organization Date: 02 Nov 1995 (30 years ago)
Last Annual Report: 21 Jun 2017 (8 years ago)
Organization Number: 0407411
ZIP code: 42701
City: Elizabethtown, E Town
Primary County: Hardin County
Principal Office: 2333 RING ROAD, ELIZABETHTOWN, KY 42701
Place of Formation: KENTUCKY
Authorized Shares: 200

President

Name Role
Jeffrey B. Richardson President

Secretary

Name Role
CHAD A BROWN Secretary

Shareholder

Name Role
CHAD A BROWN Shareholder
Jeffrey B. Richardson Shareholder

Incorporator

Name Role
JEFFREY B. RICHARDSON Incorporator

Registered Agent

Name Role
BRUCE JUSTIN FERRIELL Registered Agent

National Provider Identifier

NPI Number:
1811948524

Authorized Person:

Name:
DR. JEFFREY B. RICHARDSON
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207N00000X - Dermatology Physician
Is Primary:
Yes

Contacts:

Fax:
2707691978

Form 5500 Series

Employer Identification Number (EIN):
611293291
Plan Year:
2010
Number Of Participants:
21
Sponsors Telephone Number:
Plan Year:
2009
Number Of Participants:
22
Sponsors Telephone Number:

Assumed Names

Name Status Expiration Date
DERMSPECIALISTS Inactive 2015-04-19

Filings

Name File Date
Dissolution 2017-12-19
Annual Report 2017-06-21
Annual Report 2016-05-11
Certificate of Withdrawal of Assumed Name 2015-10-22
Certificate of Assumed Name 2015-08-05

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Sources: Kentucky Secretary of State