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KELLY BURGESS, M.D., PLLC

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Company Details

Name: KELLY BURGESS, M.D., PLLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Good
Profit or Non-Profit: Profit
File Date: 03 Jun 2005 (20 years ago)
Organization Date: 03 Jun 2005 (20 years ago)
Last Annual Report: 24 Mar 2011 (14 years ago)
Managed By: Managers
Organization Number: 0614494
ZIP code: 40324
City: Georgetown
Primary County: Scott County
Principal Office: 1140 LEXINGTON RD., SUITE 200, GEORGETOWN, KY 40324
Place of Formation: KENTUCKY

Registered Agent

Name Role
MELISSA GAYHEART Registered Agent

Manager

Name Role
Kelly Rea Burgess Manager

Organizer

Name Role
MELISSA GAYHEART Organizer

National Provider Identifier

NPI Number:
1568629418

Authorized Person:

Name:
KELLY R BURGESS
Role:
DOCTOR
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
5028634487

Filings

Name File Date
Dissolution 2012-02-15
Annual Report 2011-03-24
Annual Report 2010-03-05
Annual Report 2009-01-22
Annual Report 2008-02-13

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Sources: Kentucky Secretary of State