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MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC

Company Details

Name: MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Good Standing
Effective Date: 05 Jul 2000 (25 years ago)
Business ID: 688980
ZIP code: 39232
County: Rankin
State of Incorporation: MISSISSIPPI
Principal Office Address: 1006 TREETOPS BOULEVARD, SUITE 101FLOWOOD, MS 39232

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC 401(K) PLAN 2023 640927724 2024-07-29 MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 6019390005
Plan sponsor’s address 1006 TREETOPS BLVD. STE 101, JACKSON, MS, 39232
MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC 401(K) PLAN 2023 640927724 2024-07-29 MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC 26
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 6019390005
Plan sponsor’s address 1006 TREETOPS BLVD. STE 101, JACKSON, MS, 39232
MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC 401(K) PLAN 2022 640927724 2023-09-29 MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 6019390005
Plan sponsor’s address 1006 TREETOPS BLVD. STE 101, JACKSON, MS, 39232
MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC 401(K) PLAN 2021 640927724 2022-09-23 MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 6019390005
Plan sponsor’s address 1006 TREETOPS BLVD. STE 101, JACKSON, MS, 39232

Signature of

Role Plan administrator
Date 2022-09-23
Name of individual signing SEMANTHA GROGAN
Valid signature Filed with authorized/valid electronic signature
MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC 401(K) PLAN 2020 640927724 2021-10-13 MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 6019390005
Plan sponsor’s address 1006 TREETOPS BLVD. STE 101, JACKSON, MS, 39232

Signature of

Role Plan administrator
Date 2021-10-13
Name of individual signing SEMANTHA GROGAN
Valid signature Filed with authorized/valid electronic signature
MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC 401(K) PLAN 2019 640927724 2020-10-15 MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 6019390005
Plan sponsor’s address 1006 TREETOPS BLVD. STE 101, JACKSON, MS, 39232

Signature of

Role Plan administrator
Date 2020-10-15
Name of individual signing SEMANTHA GROGAN
Valid signature Filed with authorized/valid electronic signature
MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC 401(K) PLAN 2018 640927724 2020-10-15 MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 6019390005
Plan sponsor’s address 1006 TREETOPS BLVD. STE 101, JACKSON, MS, 39232

Signature of

Role Plan administrator
Date 2020-10-15
Name of individual signing SEMANTHA GROGAN
Valid signature Filed with authorized/valid electronic signature
MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC 401(K) PLAN 2018 640927724 2019-10-08 MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC 14
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 6019390005
Plan sponsor’s address 1006 TREETOPS BLVD. STE 101, JACKSON, MS, 39232

Signature of

Role Plan administrator
Date 2019-10-08
Name of individual signing SEMANTHA GROGAN
Valid signature Filed with authorized/valid electronic signature
MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC 401(K) PLAN 2017 640927724 2018-08-17 MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 6019390005
Plan sponsor’s address 1006 TREETOPS BLVD. STE 101, JACKSON, MS, 39232

Signature of

Role Plan administrator
Date 2018-08-17
Name of individual signing SEMANTHA GROGAN
Valid signature Filed with authorized/valid electronic signature
MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC 401(K) PLAN 2016 640927724 2017-10-03 MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 6019390005
Plan sponsor’s address 1006 TREETOPS BLVD, SUITE 101, JACKSON, MS, 39232

Signature of

Role Plan administrator
Date 2017-10-03
Name of individual signing WILLIAM BURROW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-10-03
Name of individual signing WILLIAM BURROW
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/05/29/20130529141109P040236716851001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 6019390005
Plan sponsor’s address 1006 TREETOPS BLVD, SUITE 101, JACKSON, MS, 39232

Signature of

Role Plan administrator
Date 2013-05-29
Name of individual signing WILLIAM H BURROW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-05-29
Name of individual signing WILLIAM H BURROW
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/16/20120716113123P040004392754001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 6019390005
Plan sponsor’s address 1006 TREETOPS BLVD, SUITE 101, JACKSON, MS, 39232

Plan administrator’s name and address

Administrator’s EIN 640927724
Plan administrator’s name MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC
Plan administrator’s address 1006 TREETOPS BLVD, SUITE 101, JACKSON, MS, 39232
Administrator’s telephone number 6019390005

Signature of

Role Plan administrator
Date 2012-07-16
Name of individual signing WILLIAM H BURROW, II
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-16
Name of individual signing WILLIAM H BURROW, II
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/09/27/20110927095908P040636331552001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 6019390005
Plan sponsor’s address 1006 TREETOPS BLVD, SUITE 101, JACKSON, MS, 39232

Plan administrator’s name and address

Administrator’s EIN 640927724
Plan administrator’s name MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC
Plan administrator’s address 1006 TREETOPS BLVD, SUITE 101, JACKSON, MS, 39232
Administrator’s telephone number 6019390005

Signature of

Role Plan administrator
Date 2011-09-27
Name of individual signing WILLIAM H. BURROW, II
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-09-27
Name of individual signing WILLIAM H. BURROW, II
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/09/15/20100915162744P070016635160001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 6019390005
Plan sponsor’s address 1006 TREETOPS BLVD, SUITE 101, JACKSON, MS, 39232

Plan administrator’s name and address

Administrator’s EIN 640927724
Plan administrator’s name MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC
Plan administrator’s address 1006 TREETOPS BLVD, SUITE 101, JACKSON, MS, 39232
Administrator’s telephone number 6019390005

Signature of

Role Plan administrator
Date 2010-09-15
Name of individual signing WILLIAM BURROW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-09-15
Name of individual signing WILLIAM BURROW
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
William H. Burrow II Agent 1006 Treetops Boulevard, Suite 101, Flowood, MS 39232

Member

Name Role Address
William H. Burrow II Member 1006 Treetops Boulevard, Suite 101, Flowood, MS 39232
William H. Burrow III Member 1006 Treetops Boulevard, Suite 101, Flowood, MS 39232

Filings

Type Status Filed Date Description
Annual Report LLC Filed 2024-01-22 Annual Report For MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC
Annual Report LLC Filed 2023-01-30 Annual Report For MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC
Annual Report LLC Filed 2022-01-24 Annual Report For MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC
Annual Report LLC Filed 2021-01-28 Annual Report For MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC
Annual Report LLC Filed 2020-01-22 Annual Report For MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC
Annual Report LLC Filed 2019-01-15 Annual Report For MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC
Annual Report LLC Filed 2018-01-10 Annual Report For MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC
Annual Report LLC Filed 2017-01-12 Annual Report For MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC
Annual Report LLC Filed 2016-02-11 Annual Report For MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC
Amendment Form Filed 2015-07-13 Amendment For MISSISSIPPI DERMATOLOGY ASSOCIATES, PLLC

Date of last update: 26 Dec 2024

Sources: Mississippi Secretary of State