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JOHN BROADBENT, M.D., PLLC

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Company Details

Name: JOHN BROADBENT, M.D., PLLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Good
Profit or Non-Profit: Profit
File Date: 19 Feb 2002 (23 years ago)
Organization Date: 19 Feb 2002 (23 years ago)
Last Annual Report: 23 Aug 2017 (8 years ago)
Managed By: Members
Organization Number: 0531393
ZIP code: 42086
City: West Paducah
Primary County: McCracken County
Principal Office: 1530 GHOLSON RD , WEST PADUCAH, KY 42086
Place of Formation: KENTUCKY

Manager

Name Role
John Broadbent Manager

Organizer

Name Role
JOHN BROADBENT, M.D. Organizer

Registered Agent

Name Role
JOHN BROADBENT, M.D., PLLC Registered Agent

National Provider Identifier

NPI Number:
1932249026

Authorized Person:

Name:
DONNA BALLARD
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
207RC0000X - Cardiovascular Disease Physician
Is Primary:
Yes

Contacts:

Fax:
2704414243

Form 5500 Series

Employer Identification Number (EIN):
330994721
Plan Year:
2015
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
7
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
5

Filings

Name File Date
Dissolution 2018-03-19
Annual Report 2017-08-23
Annual Report 2016-03-17
Annual Report 2015-06-13
Annual Report 2014-03-12

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Sources: Kentucky Secretary of State