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DESOTO FAMILY MEDICAL PRACTICE, P. C.

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Company Details

Name: DESOTO FAMILY MEDICAL PRACTICE, P. C.
Jurisdiction: MISSISSIPPI
Business Type: Profit Corporation
Status: Dissolved
Effective Date: 02 Jul 1996 (29 years ago)
Business ID: 631722
ZIP code: 38654
County: DeSoto
State of Incorporation: MISSISSIPPI
Principal Office Address: 7163 GOODMAN RDOLIVE BRANCH, MS 38654

Agent

Name Role Address
ROBERT P. TATE, M. D. Agent 7163 GOODMAN ROAD, OLIVE BRANCH, MS 38654

Incorporator

Name Role Address
Leeanne Marshell Cox Incorporator 130 North Court Aveune, Memphis, TN 38103

Director

Name Role Address
Robert P Tate MD Director 7163 Goodman Rd, Olive Branch, MS 38654

President

Name Role Address
Robert P Tate MD President 7163 Goodman Rd, Olive Branch, MS 38654

Secretary

Name Role Address
Karen M Tate Secretary 7163 Goodman Road, Olive Branch, MS 38654

National Provider Identifier

NPI Number:
1255343273

Authorized Person:

Name:
MRS. KAREN M TATE
Role:
SECRETARY
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
6628954886

Form 5500 Series

Employer Identification Number (EIN):
640881946
Plan Year:
2009
Number Of Participants:
9
Sponsors Telephone Number:

Filings

Type Status Filed Date Description
Admin Dissolution Filed 2014-12-20 Admin Dissolution: AR
Notice to Dissolve/Revoke Filed 2014-10-13 Notice to Dissolve/Revoke
Annual Report Filed 2013-03-23 Annual Report
Annual Report Filed 2012-03-26 Annual Report
Annual Report Filed 2011-05-18 Annual Report
Annual Report Filed 2010-03-07 Annual Report
Annual Report Filed 2009-07-04 Annual Report
Annual Report Filed 2008-04-14 Annual Report
Annual Report Filed 2007-04-02 Annual Report
Annual Report Filed 2006-12-11 Annual Report

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Date of last update: 30 Apr 2025

Sources: Company Profile on Mississippi Secretary of State Website