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JACKSON LUNG CLINIC, PLLC

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Company Details

Name: JACKSON LUNG CLINIC, PLLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Dissolved
Effective Date: 12 Nov 1999 (26 years ago)
Business ID: 678474
ZIP code: 39157
County: Madison
State of Incorporation: MISSISSIPPI
Principal Office Address: 150 Butler DriveRidgeland, MS 39157

Agent

Name Role Address
WILLIAM D FRAZIER Agent 1151 N STATE ST #304, JACKSON, MS 39202

Member

Name Role Address
JAMES T THOMAS IV Member 248 E CAPITOL ST 1400 TRUSTMARK BLDG, JACKSON, MS 39205-119
William D Frazier MD Member 150 Butler Drive, Ridgeland, MS 39157

National Provider Identifier

NPI Number:
1225105315

Authorized Person:

Name:
WILLIAM FRAZIER
Role:
MANAGING OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207RP1001X - Pulmonary Disease Physician
Is Primary:
Yes

Contacts:

Fax:
6019364389
Fax:
6013520043

Filings

Type Status Filed Date Description
Admin Dissolution Filed 2016-11-30 Admin Dissolution
Notice to Dissolve/Revoke Filed 2016-09-06 Notice to Dissolve/Revoke
Reinstatement Filed 2015-10-20 Reinstatement For JACKSON LUNG CLINIC, PLLC
Failure to File AR Filed 2011-12-05 Failure to File AR
Name Reservation Form Filed 1999-11-12 Name Reservation

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Date of last update: 03 May 2025

Sources: Company Profile on Mississippi Secretary of State Website