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Puckett Medical Clinic, LLC

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Company Details

Name: Puckett Medical Clinic, LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Dissolved
Effective Date: 02 Dec 2011 (14 years ago)
Business ID: 992495
ZIP code: 39151
County: Rankin
State of Incorporation: MISSISSIPPI
Principal Office Address: 6455 HIGHWAY 18PUCKETT, MS 39151

Agent

Name Role Address
Develin, Debra Agent 6455 Highway 18, Puckett, MS 39151

Member

Name Role Address
Debra Develin Member 6455 Highway 18, Puckett, MS 39151

Manager

Name Role Address
Debra Develin Manager 1483 SAINT JOHN ROAD, BRAXTON, MS 39044

National Provider Identifier

NPI Number:
1932476280

Authorized Person:

Name:
DEBRA DEVELIN
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QH0100X - Health Service Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
6918249533
Fax:
6018249533

Filings

Type Status Filed Date Description
Admin Dissolution Filed 2014-12-20 Admin Dissolution: AR
Notice to Dissolve/Revoke Filed 2014-10-13 Notice to Dissolve/Revoke
Annual Report LLC Filed 2013-07-22 Annual Report LLC
Notice to Dissolve/Revoke Filed 2013-07-01 Notice to Dissolve/Revoke
Annual Report LLC Filed 2012-10-08 Annual Report LLC
Notice to Dissolve/Revoke Filed 2012-09-14 Notice to Dissolve/Revoke
Amendment Form Filed 2011-12-19 Amendment
Formation Form Filed 2011-12-02 Formation

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Date of last update: 28 Jun 2025

Sources: Company Profile on Mississippi Secretary of State Website