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Hickory Flat Family Clinic, LLC

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Company Details

Name: Hickory Flat Family Clinic, LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Dissolved
Effective Date: 05 May 2008 (17 years ago)
Business ID: 931577
ZIP code: 38633
County: Benton
State of Incorporation: MISSISSIPPI
Principal Office Address: 250 OAK STREETHICKORY FLAT, MS 38633

Member

Name Role Address
Denise Gossett Member 42 CR 253, ETTA, MS 38627
Denise W. Gossett Member 42 County Road 253, Etta, MS 38627

National Provider Identifier

NPI Number:
1669649570

Authorized Person:

Name:
MS. DENISE WELLS GOSSETT
Role:
NURSE PRACTITIONER
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Filings

Type Status Filed Date Description
Agent Resignation Filed 2014-06-30 Agent Resignation
Admin Dissolution Filed 2012-12-07 Admin Dissolution
Notice to Dissolve/Revoke Filed 2012-09-14 Notice to Dissolve/Revoke
Annual Report LLC Filed 2011-04-15 Annual Report LLC
Formation Form Filed 2008-05-05 Formation

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Date of last update: 08 May 2025

Sources: Company Profile on Mississippi Secretary of State Website