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  5. MCCOMB OB-GYN ASSOCIATES, PLLC

MCCOMB OB-GYN ASSOCIATES, PLLC

Company Details

Name: MCCOMB OB-GYN ASSOCIATES, PLLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Good Standing
Effective Date: 22 May 2001 (24 years ago)
Business ID: 703151
ZIP code: 39648
County: Pike
State of Incorporation: MISSISSIPPI
Principal Office Address: 205 MARION AVENUEMCCOMB, MS 39648

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MCCOMB OB-GYN ASSOCIATES, PLLC 401(K) PROFIT SHARING PLAN 2023 640940975 2024-08-28 MCCOMB OB-GYN ASSOCIATES, PLLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-07-09
Business code 621111
Sponsor’s telephone number 6016849116
Plan sponsor’s address 205 MARION AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2024-08-28
Name of individual signing SUSIE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
MCCOMB OB-GYN ASSOCIATES, PLLC 401(K) PROFIT SHARING PLAN 2022 640940975 2023-04-25 MCCOMB OB-GYN ASSOCIATES, PLLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-07-09
Business code 621111
Sponsor’s telephone number 6016849116
Plan sponsor’s address 205 MARION AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2023-04-25
Name of individual signing SUSIE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
MCCOMB OB-GYN ASSOCIATES, PLLC 401(K) PROFIT SHARING PLAN 2021 640940975 2022-07-13 MCCOMB OB-GYN ASSOCIATES, PLLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-07-09
Business code 621111
Sponsor’s telephone number 6016849116
Plan sponsor’s address 205 MARION AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2022-07-13
Name of individual signing DAWN SUMRALL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-07-13
Name of individual signing DAWN SUMRALL
Valid signature Filed with authorized/valid electronic signature
MCCOMB OB-GYN ASSOCIATES, PLLC 401(K) PROFIT SHARING PLAN 2020 640940975 2021-04-20 MCCOMB OB-GYN ASSOCIATES, PLLC 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-07-09
Business code 621111
Sponsor’s telephone number 6016849116
Plan sponsor’s address 205 MARION AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2021-04-20
Name of individual signing DAWN SUMRALL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-20
Name of individual signing DAWN SUMRALL
Valid signature Filed with authorized/valid electronic signature
MCCOMB OB-GYN ASSOCIATES, PLLC 401(K) PROFIT SHARING PLAN 2019 640940975 2020-04-22 MCCOMB OB-GYN ASSOCIATES, PLLC 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-07-09
Business code 621111
Sponsor’s telephone number 6016849116
Plan sponsor’s address 205 MARION AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2020-04-22
Name of individual signing DAWN SUMRALL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-04-22
Name of individual signing DAWN SUMRALL
Valid signature Filed with authorized/valid electronic signature
MCCOMB OB-GYN ASSOCIATES, PLLC 401(K) PROFIT SHARING PLAN 2018 640940975 2019-08-19 MCCOMB OB-GYN ASSOCIATES, PLLC 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-07-09
Business code 621111
Sponsor’s telephone number 6016849116
Plan sponsor’s address 205 MARION AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2019-08-19
Name of individual signing DAWN SUMRALLL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-08-19
Name of individual signing DAWN SUMRALLL
Valid signature Filed with authorized/valid electronic signature
MCCOMB OB-GYN ASSOCIATES, PLLC 401(K) PROFIT SHARING PLAN 2017 640940975 2018-10-11 MCCOMB OB-GYN ASSOCIATES, PLLC 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-07-09
Business code 621111
Sponsor’s telephone number 6016849116
Plan sponsor’s address 205 MARION AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2018-10-11
Name of individual signing DAWN SUMRALL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-11
Name of individual signing DAWN SUMRALL
Valid signature Filed with authorized/valid electronic signature
MCCOMB OB-GYN ASSOCIATES, PLLC 401(K) PROFIT SHARING PLAN 2016 640940975 2017-09-14 MCCOMB OB-GYN ASSOCIATES, PLLC 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-07-09
Business code 621111
Sponsor’s telephone number 6016849116
Plan sponsor’s address 205 MARION AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2017-09-14
Name of individual signing DAWN SUMRALL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-09-14
Name of individual signing DAWN SUMRALL
Valid signature Filed with authorized/valid electronic signature
MCCOMB OB-GYN ASSOCIATES, PLLC 401(K) PROFIT SHARING PLAN 2015 640940975 2016-09-28 MCCOMB OB-GYN ASSOCIATES, PLLC 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-07-09
Business code 621111
Sponsor’s telephone number 6016849116
Plan sponsor’s address 205 MARION AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2016-09-28
Name of individual signing SUSIE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-09-28
Name of individual signing SUSIE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
MCCOMB OB-GYN ASSOCIATES, PLLC 401(K) PROFIT SHARING PLAN 2014 640940975 2015-10-07 MCCOMB OB-GYN ASSOCIATES, PLLC 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-07-09
Business code 621111
Sponsor’s telephone number 6016849116
Plan sponsor’s address 205 MARION AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2015-10-07
Name of individual signing DAWN SUMRALL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-07
Name of individual signing DAWN SUMRALL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/10/08/20141008075412P040013923983001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-07-09
Business code 621111
Sponsor’s telephone number 6016849116
Plan sponsor’s address 205 MARION AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2014-10-08
Name of individual signing DAWN SUMRALL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-08
Name of individual signing DAWN SUMRALL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/05/31/20130531094318P030084291845001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-07-09
Business code 621111
Sponsor’s telephone number 6016849116
Plan sponsor’s address 205 MARION AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2013-05-31
Name of individual signing DAWN SUMRALL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-05-31
Name of individual signing DAWN SUMRALL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/04/03/20120403100148P030009925910001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-07-09
Business code 621111
Sponsor’s telephone number 6016849116
Plan sponsor’s address 205 MARION AVENUE, MCCOMB, MS, 39648

Plan administrator’s name and address
Administrator’s EIN 640940975
Plan administrator’s name MCCOMB OB-GYN ASSOCIATES, PLLC
Plan administrator’s address 205 MARION AVENUE, MCCOMB, MS, 39648
Administrator’s telephone number 6016849116

Signature of
Role Plan administrator
Date 2012-04-03
Name of individual signing DAWN SUMRALL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-04-03
Name of individual signing DAWN SUMRALL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/04/22/20110422124411P030014455575001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-07-09
Business code 621111
Sponsor’s telephone number 6016849116
Plan sponsor’s address 205 MARION AVENUE, MCCOMB, MS, 39648

Plan administrator’s name and address
Administrator’s EIN 640940975
Plan administrator’s name MCCOMB OB-GYN ASSOCIATES, PLLC
Plan administrator’s address 205 MARION AVENUE, MCCOMB, MS, 39648
Administrator’s telephone number 6016849116

Signature of
Role Plan administrator
Date 2011-04-22
Name of individual signing DAWN SUMRALL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-04-22
Name of individual signing DAWN SUMRALL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/22/20100722090642P030088451432001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-07-09
Business code 621111
Sponsor’s telephone number 6016849116
Plan sponsor’s address 205 MARION AVENUE, MCCOMB, MS, 39648

Plan administrator’s name and address
Administrator’s EIN 640940975
Plan administrator’s name MCCOMB OB-GYN ASSOCIATES, PLLC
Plan administrator’s address 205 MARION AVENUE, MCCOMB, MS, 39648
Administrator’s telephone number 6016849116

Signature of
Role Plan administrator
Date 2010-07-22
Name of individual signing SUSIE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-22
Name of individual signing SUSIE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Sumrall, Dawn M Agent 205 Marion Avenue;P O Box 1348, McComb, MS 39649

Manager

Name Role Address
Susie Fortenberry Manager 205 MARION AVENUE, MCCOMB, MS 39648

Filings

Type Status Filed Date Description
Annual Report LLC Filed 2025-01-27 Annual Report For MCCOMB OB-GYN ASSOCIATES, PLLC
Annual Report LLC Filed 2024-01-31 Annual Report For MCCOMB OB-GYN ASSOCIATES, PLLC
Annual Report LLC Filed 2023-12-04 Annual Report For MCCOMB OB-GYN ASSOCIATES, PLLC
Annual Report LLC Filed 2023-02-13 Annual Report For MCCOMB OB-GYN ASSOCIATES, PLLC
Annual Report LLC Filed 2022-10-05 Annual Report For MCCOMB OB-GYN ASSOCIATES, PLLC
Notice to Dissolve/Revoke Filed 2022-09-05 Notice of Intent to Dissolve: AR: MCCOMB OB-GYN ASSOCIATES, PLLC
Annual Report LLC Filed 2021-03-08 Annual Report For MCCOMB OB-GYN ASSOCIATES, PLLC
Annual Report LLC Filed 2020-03-31 Annual Report For MCCOMB OB-GYN ASSOCIATES, PLLC
Annual Report LLC Filed 2019-03-28 Annual Report For MCCOMB OB-GYN ASSOCIATES, PLLC
Annual Report LLC Filed 2018-04-11 Annual Report For MCCOMB OB-GYN ASSOCIATES, PLLC

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
2361887201 2020-04-16 0470 PPP 205 MARION AVE, MCCOMB, MS, 39648-2705
Loan Status Date 2021-05-21
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 157515
Loan Approval Amount (current) 157515
Undisbursed Amount 0
Franchise Name -
Lender Location ID 39334
Servicing Lender Name Trustmark National Bank
Servicing Lender Address 248 E Capitol St, JACKSON, MS, 39201-2503
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address MCCOMB, PIKE, MS, 39648-2705
Project Congressional District MS-03
Number of Employees 15
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Sole Proprietorship
Originating Lender ID 39334
Originating Lender Name Trustmark National Bank
Originating Lender Address JACKSON, MS
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 159107.65
Forgiveness Paid Date 2021-05-10

Related by officers

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Date of last update: 19 Mar 2025

Sources: Mississippi Secretary of State

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