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J. BRIAN FREDERICK, M.D., PLLC

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Company Details

Name: J. BRIAN FREDERICK, M.D., PLLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Bad
File Date: 16 Jun 2005 (20 years ago)
Organization Date: 16 Jun 2005 (20 years ago)
Last Annual Report: 09 Aug 2023 (2 years ago)
Managed By: Members
Organization Number: 0615532
ZIP code: 41105
City: Ashland, Summitt
Primary County: Boyd County
Principal Office: P.O. BOX 1327, ASHLAND, KY 41105-1327
Place of Formation: KENTUCKY

Registered Agent

Name Role
J. BRIAN FREDERICK, MD, PLLC Registered Agent

Member

Name Role
J BRIAN FREDERICK Member

Organizer

Name Role
C. BRADFORD HARRIS Organizer

National Provider Identifier

NPI Number:
1437356532

Authorized Person:

Name:
JAMES BRIAN FREDERICK
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
174400000X - Specialist
Is Primary:
Yes

Contacts:

Fax:
6063269368

Filings

Name File Date
Administrative Dissolution 2024-10-12
Reinstatement Approval Letter Revenue 2023-08-09
Reinstatement 2023-08-09
Reinstatement Certificate of Existence 2023-08-09
Administrative Dissolution 2022-10-04

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Sources: Kentucky Secretary of State