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Fondren Medical Clinic LLC

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Company Details

Name: Fondren Medical Clinic LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Dissolved
Effective Date: 13 Dec 2011 (13 years ago)
Business ID: 993021
ZIP code: 39206
County: Hinds
State of Incorporation: MISSISSIPPI
Principal Office Address: 4436 NORHT STATE STREET SUITE A1JACKSON, MS 39206

Agent

Name Role Address
Lane-Fisher, Theresa Agent 331 Red Eagle Circle, Ridgeland, MS 39157

Member

Name Role Address
Theresa Lane-Fisher Member 331 Red Eagle Circle, Ridgeland, MS 39157
Shawn E Pickering Member 331 Red Eagle Circle, Ridgeland, MS 39157

Manager

Name Role Address
Theresa Lane-Fisher Manager 768 OAKMONT PARKWAY, RIDGELAND, MS 39157

National Provider Identifier

NPI Number:
1043573199

Authorized Person:

Name:
DR. THERESA LEIJUAN LANE-FISHER
Role:
PHYSICIAN/OWNER
Phone:

Taxonomy:

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

Contacts:

Filings

Type Status Filed Date Description
Admin Dissolution Filed 2015-12-08 Admin Dissolution: AR
Notice to Dissolve/Revoke Filed 2015-09-16 Notice to Dissolve/Revoke
Annual Report LLC Filed 2014-01-29 Annual Report LLC
Annual Report LLC Filed 2013-04-13 Annual Report LLC
Annual Report LLC Filed 2012-09-27 Annual Report LLC
Notice to Dissolve/Revoke Filed 2012-09-14 Notice to Dissolve/Revoke
Formation Form Filed 2011-12-13 Formation

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Date of last update: 11 May 2025

Sources: Company Profile on Mississippi Secretary of State Website