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C. CRAIG STAFFORD, MD PSC

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Company Details

Name: C. CRAIG STAFFORD, MD PSC
Legal type: Kentucky Professional Services Corp
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 14 Sep 2010 (15 years ago)
Organization Date: 14 Sep 2010 (15 years ago)
Last Annual Report: 17 Mar 2016 (9 years ago)
Organization Number: 0771280
ZIP code: 40504
City: Lexington
Primary County: Fayette County
Principal Office: 1401 HARRODSBURG ROAD, SUITE-450, LEXINGTON, KY 40504
Place of Formation: KENTUCKY
Authorized Shares: 1000

Shareholder

Name Role
C. CRAIG STAFFORD Shareholder

Incorporator

Name Role
C. CRAIG STAFFORD Incorporator

Registered Agent

Name Role
BENNETT E BAYER Registered Agent

President

Name Role
C. CRAIG STAFFORD President

Vice President

Name Role
C. CRAIG STAFFORD Vice President

National Provider Identifier

NPI Number:
1831408046

Authorized Person:

Name:
CHARLES CRAIG STAFFORD
Role:
OWNER/MD
Phone:

Taxonomy:

Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
207RN0300X - Nephrology Physician
Is Primary:
Yes

Contacts:

Fax:
8593730235

Filings

Name File Date
Administrative Dissolution 2017-10-09
Annual Report 2016-03-17
Annual Report 2015-04-21
Annual Report 2014-03-06
Annual Report 2013-01-30

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Sources: Kentucky Secretary of State