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FACIAL PLASTIC SURGERY & DERMATOLOGY, PLLC

Company Details

Name: FACIAL PLASTIC SURGERY & DERMATOLOGY, PLLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Good
Profit or Non-Profit: Profit
File Date: 10 May 2013 (12 years ago)
Organization Date: 10 May 2013 (12 years ago)
Last Annual Report: 31 Jul 2014 (11 years ago)
Managed By: Members
Organization Number: 0857369
ZIP code: 40513
City: Lexington
Primary County: Fayette County
Principal Office: 3070 LAKECREST CIRCLE, SUITE 400-264, LEXINGTON, KY 40513
Place of Formation: KENTUCKY

Member

Name Role
SAMUEL BRIDEN Member

Registered Agent

Name Role
MICHAEL C. SLONE Registered Agent

Organizer

Name Role
SAM PRUDEN, M.D. Organizer

National Provider Identifier

NPI Number:
1881030088

Authorized Person:

Name:
SAMUEL JACK PRUDEN II
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207N00000X - Dermatology Physician
Is Primary:
No
Selected Taxonomy:
208200000X - Plastic Surgery Physician
Is Primary:
No
Selected Taxonomy:
207ND0101X - MOHS-Micrographic Surgery Physician
Is Primary:
Yes

Contacts:

Fax:
8592260207

Filings

Name File Date
Dissolution 2015-04-28
Annual Report 2014-07-31
Articles of Organization (LLC) 2013-05-10

Sources: Kentucky Secretary of State