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GEORGE E. WILKERSON, M.D., P.A.

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Company Details

Name: GEORGE E. WILKERSON, M.D., P.A.
Jurisdiction: MISSISSIPPI
Business Type: Profit Corporation
Status: Dissolved
Effective Date: 28 Mar 1984 (41 years ago)
Business ID: 515247
ZIP code: 39482
County: Lamar
State of Incorporation: MISSISSIPPI
Principal Office Address: 74 Aultman RdSumrall, MS 39482

Agent

Name Role Address
GEORGE E WILKERSON Agent 348 CROSSGATES BLVD #2300, BRANDON, MS 39042

Director

Name Role Address
PAMELA WILKERSON Director No data
MICHAEL K RANDOLPH Director 105 ASBURY CIRCLEE, , MS
George E Wilkerson Director 500 Beacon Cv, Brandon, MS 39042
GEORGE E WILKERSON Director 701 SOUTH 28TH AVENUE, SUITE C, HATTIESBURG, MS

Vice President

Name Role Address
PAMELA WILKERSON Vice President No data
George E Wilkerson Vice President 500 Beacon Cv, Brandon, MS 39042
Carolina Aultman Vice President 348 CROSSGATES BLVD #2300, BRANDON, MS 39042

President

Name Role Address
GEORGE E WILKERSON President 701 SOUTH 28TH AVENUE, SUITE C, HATTIESBURG, MS
George E Wilkerson President 348 CROSSGATES BLVD #2300, BRANDON, MS 39042

Secretary

Name Role Address
MICHAEL K RANDOLPH Secretary 105 ASBURY CIRCLEE, , MS
Carolina Aultman Secretary 348 CROSSGATES BLVD #2300, BRANDON, MS 39042
George E Wilkerson Secretary 500 Beacon Cv, Brandon, MS 39042

Incorporator

Name Role Address
GEORGE E WILKERSON Incorporator 701 SOUTH 28TH AVENUE, SUITE C, HATTIESBURG, MS

Treasurer

Name Role Address
George E Wilkerson Treasurer 500 Beacon Cv, Brandon, MS 39042

National Provider Identifier

NPI Number:
1598911877

Authorized Person:

Name:
DR. GEORGE EDWARD WILKERSON
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
261QM2500X - Medical Specialty Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
6018246042

Form 5500 Series

Employer Identification Number (EIN):
640692314
Plan Year:
2009
Number Of Participants:
7
Sponsors Telephone Number:
Plan Year:
2009
Number Of Participants:
7
Sponsors Telephone Number:

Filings

Type Status Filed Date Description
Admin Dissolution Filed 2011-12-05 Admin Dissolution
Notice to Dissolve/Revoke Filed 2011-07-25 Notice to Dissolve/Revoke
Annual Report Filed 2010-04-05 Annual Report
Annual Report Filed 2009-04-20 Annual Report
Reinstatement Filed 2007-10-29 Reinstatement
Amendment Form Filed 2003-08-27 Amendment
Admin Dissolution Filed 1991-03-05 Admin Dissolution
Notice to Dissolve/Revoke Filed 1990-11-07 Notice to Dissolve/Revoke
Annual Report Filed 1989-12-14 Annual Report
Notice to Dissolve/Revoke Filed 1989-10-26 Notice to Dissolve/Revoke

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Date of last update: 14 Jun 2025

Sources: Company Profile on Mississippi Secretary of State Website