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HAZARD INTERNAL MEDICINE, P.S.C.

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Company Details

Name: HAZARD INTERNAL MEDICINE, P.S.C.
Legal type: Kentucky Professional Services Corp
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 26 May 2005 (20 years ago)
Organization Date: 26 May 2005 (20 years ago)
Last Annual Report: 27 Mar 2008 (17 years ago)
Organization Number: 0613900
ZIP code: 41701
City: Hazard, Browns Fork, Typo, Walkertown
Primary County: Perry County
Principal Office: SUITE A, 243 ROY CAMPBELL DRIVE, HAZARD, KY 41701
Place of Formation: KENTUCKY
Authorized Shares: 100

Registered Agent

Name Role
THOMAS E. KARELIS, JR., M.D. Registered Agent

Sole Officer

Name Role
THOMAS E KARELIS, JR. Sole Officer

Shareholder

Name Role
THOMAS E KARELIS Shareholder

Signature

Name Role
THOMAS KARELIS Signature

Incorporator

Name Role
THOMAS E. KARELIS, JR., M.D. Incorporator

National Provider Identifier

NPI Number:
1821211996

Authorized Person:

Name:
DR. THOMAS E. KARELIS JR.
Role:
PRESIDENT, HAZARD INTERNAL MEDICINE
Phone:

Taxonomy:

Selected Taxonomy:
363A00000X - Physician Assistant
Is Primary:
No
Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
6064870396

Filings

Name File Date
Administrative Dissolution 2009-11-03
Annual Report 2008-03-27
Annual Report 2007-09-05
Annual Report 2006-05-03
Articles of Incorporation 2005-05-26

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Sources: Kentucky Secretary of State