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  5. MISSISSIPPI UROLOGY CLINIC, PLLC

MISSISSIPPI UROLOGY CLINIC, PLLC

Company Details

Name: MISSISSIPPI UROLOGY CLINIC, PLLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Good Standing
Effective Date: 20 Nov 1996 (28 years ago)
Business ID: 636203
ZIP code: 39202
County: Hinds
State of Incorporation: MISSISSIPPI
Principal Office Address: 501 Marshall St., #301Jackson, MS 39202

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MISSISSIPPI UROLOGY CLINIC, P.A. PROFIT-SHARING PLAN 2012 640884577 2015-10-06 MISSISSIPPI UROLOGY CLINIC, PLLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-11-01
Business code 621111
Sponsor’s telephone number 6013539900
Plan sponsor’s address 1421 NORTH STATE STREET SUITE 403, JACKSON, MS, 392021658

Signature of
Role Plan administrator
Date 2015-10-06
Name of individual signing JOSEPH A HOUSE
Valid signature Filed with authorized/valid electronic signature
MISSISSIPPI UROLOGY CLINIC, P.A. PROFIT-SHARING PLAN 2011 640884577 2013-05-23 MISSISSIPPI UROLOGY CLINIC, PLLC 16
Three-digit plan number (PN) 001
Effective date of plan 1975-11-01
Business code 621111
Sponsor’s telephone number 6013539900
Plan sponsor’s address 1421 NORTH STATE STREET SUITE 403, JACKSON, MS, 392021658

Plan administrator’s name and address
Administrator’s EIN 640884577
Plan administrator’s name MISSISSIPPI UROLOGY CLINIC, PLLC
Plan administrator’s address 1421 NORTH STATE STREET SUITE 403, JACKSON, MS, 392021658
Administrator’s telephone number 6013539900

Signature of
Role Plan administrator
Date 2013-05-23
Name of individual signing JOSEPH A HOUSE
Valid signature Filed with authorized/valid electronic signature
MISSISSIPPI UROLOGY CLINIC, P.A. PROFIT-SHARING PLAN 2011 640884577 2014-03-19 MISSISSIPPI UROLOGY CLINIC, PLLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-11-01
Business code 621111
Sponsor’s telephone number 6013539900
Plan sponsor’s address 1421 NORTH STATE STREET SUITE 403, JACKSON, MS, 392021658

Plan administrator’s name and address
Administrator’s EIN 640884577
Plan administrator’s name MISSISSIPPI UROLOGY CLINIC, PLLC
Plan administrator’s address 1421 NORTH STATE STREET SUITE 403, JACKSON, MS, 392021658
Administrator’s telephone number 6013539900

Signature of
Role Plan administrator
Date 2014-03-19
Name of individual signing JOSEPH A HOUSE
Valid signature Filed with authorized/valid electronic signature
MISSISSIPPI UROLOGY CLINIC, P.A. PROFIT-SHARING PLAN 2011 640884577 2014-03-19 MISSISSIPPI UROLOGY CLINIC, PLLC 16
Three-digit plan number (PN) 001
Effective date of plan 1975-11-01
Business code 621111
Sponsor’s telephone number 6013539900
Plan sponsor’s address 1421 NORTH STATE STREET SUITE 403, JACKSON, MS, 392021658

Plan administrator’s name and address
Administrator’s EIN 640884577
Plan administrator’s name MISSISSIPPI UROLOGY CLINIC, PLLC
Plan administrator’s address 1421 NORTH STATE STREET SUITE 403, JACKSON, MS, 392021658
Administrator’s telephone number 6013539900

Signature of
Role Plan administrator
Date 2014-03-19
Name of individual signing JOSEPH A HOUSE
Valid signature Filed with authorized/valid electronic signature
MISSISSIPPI UROLOGY CLINIC, P.A. PROFIT-SHARING PLAN 2010 640884577 2012-08-15 MISSISSIPPI UROLOGY CLINIC, PLLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-11-01
Business code 621111
Sponsor’s telephone number 6013539900
Plan sponsor’s address 1421 NORTH STATE STREET SUITE 403, JACKSON, MS, 392021658

Plan administrator’s name and address
Administrator’s EIN 640884577
Plan administrator’s name MISSISSIPPI UROLOGY CLINIC, PLLC
Plan administrator’s address 1421 NORTH STATE STREET SUITE 403, JACKSON, MS, 392021658
Administrator’s telephone number 6013539900

Signature of
Role Plan administrator
Date 2012-08-15
Name of individual signing JOSEPH HOUSE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Harold Jason Blalock MD Agent 501 Marshall Street, Suite 301, Jackson, MS 39202

Member

Name Role Address
Patrick Daily Member 501 Marshall St., #201, Jackson, MS 39202

Manager

Name Role Address
H. Jason Blalock Manager 501 Marshall St., #201, Jackson, MS 39202

President

Name Role Address
H. Jason Blalock President 501 Marshall St., #201, Jackson, MS 39202

Filings

Type Status Filed Date Description
Annual Report LLC Filed 2024-01-30 Annual Report For MISSISSIPPI UROLOGY CLINIC, PLLC
Amendment Form Filed 2023-10-18 Amendment For MISSISSIPPI UROLOGY CLINIC, PLLC
Agent Resignation Filed 2023-10-18 Agent Resignation For WILLIAM S PAINTER
Annual Report LLC Filed 2023-03-10 Annual Report For MISSISSIPPI UROLOGY CLINIC, PLLC
Annual Report LLC Filed 2022-03-03 Annual Report For MISSISSIPPI UROLOGY CLINIC, PLLC
Annual Report LLC Filed 2021-01-15 Annual Report For MISSISSIPPI UROLOGY CLINIC, PLLC
Annual Report LLC Filed 2020-01-15 Annual Report For MISSISSIPPI UROLOGY CLINIC, PLLC
Annual Report LLC Filed 2019-02-25 Annual Report For MISSISSIPPI UROLOGY CLINIC, PLLC
Annual Report LLC Filed 2018-04-04 Annual Report For MISSISSIPPI UROLOGY CLINIC, PLLC
Annual Report LLC Filed 2017-01-17 Annual Report For MISSISSIPPI UROLOGY CLINIC, PLLC

Related by officers

Harold Jason Blalock MD

Urology Healthcare Properties, LLC

Patrick Daily

White Sands Inc of Mississippi

H. Jason Blalock

Mississippi Urology Outpatient Surgery Center, LLC A&B Realty LLC A&B Holding LLC

Related by address

501 Marshall St., #301Jackson, MS 39202

Urology Healthcare Properties, LLC

Date of last update: 24 Dec 2024

Sources: Mississippi Secretary of State

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