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SOUTHERN KENTUCKY VASCULAR CLINIC PLLC

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Company Details

Name: SOUTHERN KENTUCKY VASCULAR CLINIC PLLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 15 Apr 2022 (3 years ago)
Organization Date: 15 Apr 2022 (3 years ago)
Last Annual Report: 15 Mar 2025 (3 months ago)
Managed By: Members
Organization Number: 1202908
Industry: Health Services
Number of Employees: Medium (20-99)
ZIP code: 42503
City: Somerset
Primary County: Pulaski County
Principal Office: 50 MEDPARK SQUARE DRIVE SUITE 3, SOMERSET, KY 42503
Place of Formation: KENTUCKY

Registered Agent

Name Role
DON W. BROWN Registered Agent

Member

Name Role
Donald Wayne Brown Member

Organizer

Name Role
WT&C CORPORATE SERVICES, INC. Organizer

National Provider Identifier

NPI Number:
1760111553
Certification Date:
2023-12-08

Authorized Person:

Name:
DONALD W. BROWN
Role:
PHYSICIAN/OWNER
Phone:

Taxonomy:

Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
2086S0129X - Vascular Surgery Physician
Is Primary:
Yes

Contacts:

Fax:
6062202116

Form 5500 Series

Employer Identification Number (EIN):
882241660
Plan Year:
2023
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
6
Sponsors Telephone Number:

Filings

Name File Date
Annual Report 2025-03-15
Registered Agent name/address change 2024-07-31
Annual Report Amendment 2024-04-14
Annual Report 2024-04-14
Annual Report 2023-08-08

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Sources: Kentucky Secretary of State