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Blake Surgical Association, PLLC

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Company Details

Name: Blake Surgical Association, PLLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Dissolved
Effective Date: 11 Aug 2005 (20 years ago)
Business ID: 876540
ZIP code: 38732
County: Bolivar
State of Incorporation: MISSISSIPPI
Principal Office Address: 907 E SUNFLOWER ROAD, SUITE 101CLEVELAND, MS 38732

Agent

Name Role Address
Blake, Roger A. C. Agent 907 E Sunflower Road #101, Cleveland, MS 38732

Member

Name Role Address
Vicki Blake Member 907 E SUNFLOWER ROAD #101, CLEVELAND, MS 38732
Roger A. C. Blake Member 901 East Sunflower Road, Cleveland, MS 38732

President

Name Role Address
Roger Blake President NULL, NULL, MS NULL

National Provider Identifier

NPI Number:
1154521466
Certification Date:
2020-08-30

Authorized Person:

Name:
DR. ROGER BLAKE
Role:
OWNER/PHYSICIAN
Phone:

Taxonomy:

Selected Taxonomy:
208600000X - Surgery Physician
Is Primary:
No
Selected Taxonomy:
2086S0102X - Surgical Critical Care Physician
Is Primary:
Yes

Contacts:

Fax:
6628468886

Filings

Type Status Filed Date Description
Admin Dissolution Filed 2024-12-01 Action of Intent to Dissolve: AR: Blake Surgical Association, PLLC
Notice to Dissolve/Revoke Filed 2024-09-01 Notice of Intent to Dissolve: AR: Blake Surgical Association, PLLC
Annual Report LLC Filed 2023-02-04 Annual Report For Blake Surgical Association, PLLC
Annual Report LLC Filed 2022-02-20 Annual Report For Blake Surgical Association, PLLC
Annual Report LLC Filed 2021-04-10 Annual Report For Blake Surgical Association, PLLC
Annual Report LLC Filed 2020-03-02 Annual Report For Blake Surgical Association, PLLC
Annual Report LLC Filed 2019-03-26 Annual Report For Blake Surgical Association, PLLC
Annual Report LLC Filed 2018-02-10 Annual Report For Blake Surgical Association, PLLC
Annual Report LLC Filed 2017-03-18 Annual Report For Blake Surgical Association, PLLC
Annual Report LLC Filed 2016-04-09 Annual Report For Blake Surgical Association, PLLC

USAspending Awards / Financial Assistance

Date:
2021-02-05
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
64980.00
Total Face Value Of Loan:
64980.00
Date:
2020-06-25
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO PROVIDE LOANS TO RESTORE AS NEARLY AS POSSIBLE THE VICTIMS OF ECONOMIC INJURY TYPE DISASTERS TO PRE-DISASTER CONDITIONS
Obligated Amount:
0.00
Face Value Of Loan:
150000.00
Total Face Value Of Loan:
150000.00
Date:
2020-04-22
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
15000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-04-09
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
64980.00
Total Face Value Of Loan:
64980.00

Paycheck Protection Program

Date Approved:
2020-04-09
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
64980
Current Approval Amount:
64980
Race:
Black or African American
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
65439.31
Date Approved:
2021-02-05
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
64980
Current Approval Amount:
64980
Race:
Black or African American
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
65480.26

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Date of last update: 05 May 2025

Sources: Company Profile on Mississippi Secretary of State Website