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Magnolia Internal Medicine Clinic, PLLC

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Company Details

Name: Magnolia Internal Medicine Clinic, PLLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Dissolved
Effective Date: 16 Jun 2006 (19 years ago)
Business ID: 894009
State of Incorporation: MISSISSIPPI
Historical names: Magnolia Internal Medical Clinic, LLC
Magnolia Internal Medical Clinic, PLLC

Agent

Name Role Address
Miller, Adam Agent 1520 Government Street, Ocean Springs, MS 39564

Member

Name Role Address
Jeanmarie McDaniel Member 759 Vieux Marche' Mall PO Box 289, Biloxi, MS 39533

National Provider Identifier

NPI Number:
1316106255

Authorized Person:

Name:
DONALD R LLOYD
Role:
CPO
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Filings

Type Status Filed Date Description
Failure to File AR Filed 2011-12-05 Failure to File AR
Amendment Form Filed 2006-09-12 Amendment
Amendment Form Filed 2006-06-30 Amendment
Formation Form Filed 2006-06-16 Formation

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Date of last update: 06 May 2025

Sources: Company Profile on Mississippi Secretary of State Website