| Name: | THE VICKSBURG CLINIC, P.A. |
| Jurisdiction: | MISSISSIPPI |
| Business Type: | Profit Corporation |
| Effective Date: | 29 Dec 1994 (30 years ago) |
| Business ID: | 613555 |
| ZIP code: | 39182 |
| County: | Warren |
| State of Incorporation: | MISSISSIPPI |
| Principal Office Address: | 1115 N FRONTAGE ROADVICKSBURG, MS 39182-154 |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY | Agent | 109 Executive Drive, Suite 3, Madison, MS 39110 |
| Name | Role | Address |
|---|---|---|
| R. E. SASSONE, M.D. | Director | 1115 N. FRONTAGE ROAD, VICKSBURG, MS 39180 |
| J. DAVID FAGAN, M.D. | Director | 1115 N. FRONTAGE ROAD, VICKSBURG, MS 39180 |
| H. K. KUIPER, M.D. | Director | 1115 N. FRONTAGE ROAD, VICKSBURG, MS 39180 |
| Name | Role | Address |
|---|---|---|
| R. E. SASSONE, M.D. | Secretary | 1115 N. FRONTAGE ROAD, VICKSBURG, MS 39180 |
| Name | Role | Address |
|---|---|---|
| R. E. SASSONE, M.D. | Treasurer | 1115 N. FRONTAGE ROAD, VICKSBURG, MS 39180 |
| Name | Role | Address |
|---|---|---|
| J. DAVID FAGAN, M.D. | Vice President | 1115 N. FRONTAGE ROAD, VICKSBURG, MS 39180 |
| Name | Role | Address |
|---|---|---|
| H. K. KUIPER, M.D. | President | 1115 N. FRONTAGE ROAD, VICKSBURG, MS 39180 |
| Name | Role | Address |
|---|---|---|
| DAVID FAGAN MD | Incorporator | 1115 N FRONTAGE RD, VICKSBURG, MS 39182-154 |
| Type | Status | Filed Date | Description |
|---|---|---|---|
| Registered Agent Change of Address | Filed | 2022-03-31 | Agent Address Change For CORPORATION SERVICE COMPANY |
| Registered Agent Change of Address | Filed | 2016-02-03 | Agent Address Change For CORPORATION SERVICE COMPANY |
| Amendment Form | Filed | 1997-08-22 | Amendment |
Date of last update: 23 Dec 2024
Sources: Mississippi Secretary of State
