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Mississippi PHS MD, LLC

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Company Details

Name: Mississippi PHS MD, LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Dissolved
Effective Date: 25 Sep 2015 (10 years ago)
Business ID: 1076623
State of Incorporation: MISSISSIPPI

Agent

Name Role Address
NATIONAL REGISTERED AGENTS INC Agent 645 Lakeland East Drive, Suite 101, Flowood, MS 39232

Manager

Name Role Address
Nicole Howard Manager 1509 Dulles Drive, Lafayette, LA 70506

National Provider Identifier

NPI Number:
1265803985

Authorized Person:

Name:
NICOLE HOWARD
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
207QG0300X - Geriatric Medicine (Family Medicine) Physician
Is Primary:
No
Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Filings

Type Status Filed Date Description
Dissolution Filed 2015-11-02 Dissolution For Mississippi PHS MD, LLC
Formation Form Filed 2015-09-25 Formation For Mississippi PHS MD, LLC

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Date of last update: 03 Jul 2025

Sources: Company Profile on Mississippi Secretary of State Website