-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, HKIeIoDo//y6l3ax+9EOSYRi4riKkB+mpZnJ2b0L09oEiFVvnhVSWuprVoI7dfYp VneCa/kk27QG5THnzKhVYQ== 0001209191-04-027183.txt : 20040521 0001209191-04-027183.hdr.sgml : 20040521 20040521161115 ACCESSION NUMBER: 0001209191-04-027183 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040520 FILED AS OF DATE: 20040521 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AMSURG CORP CENTRAL INDEX KEY: 0000895930 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-OFFICES & CLINICS OF DOCTORS OF MEDICINE [8011] IRS NUMBER: 621493316 STATE OF INCORPORATION: TN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 20 BURTON HILLS BLVD STREET 2: STE 350 CITY: NASHVILLE STATE: TN ZIP: 37215 BUSINESS PHONE: 6156651283 MAIL ADDRESS: STREET 1: ONE BURTON HILLS BLVD. STREET 2: SUITE 350 CITY: NASHVILLE STATE: TN ZIP: 37215 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: OVERHOLT BERGEIN F CENTRAL INDEX KEY: 0001203381 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-22217 FILM NUMBER: 04824373 BUSINESS ADDRESS: STREET 1: C/O AMSURG CORP STREET 2: 20 BURTON HILLS BLVD STE 500 CITY: NASHVILLE STATE: TN ZIP: 37215 BUSINESS PHONE: 6156651283 MAIL ADDRESS: STREET 1: C/O AMSURG CORP STREET 2: 20 BURTON HILLS BLVD STE 500 CITY: NASHVILLE STATE: TN ZIP: 37215 4 1 doc4.xml FORM 4 SUBMISSION X0202 4 2004-05-20 0 0000895930 AMSURG CORP AMSG 0001203381 OVERHOLT BERGEIN F 801 WEISGARBER RD. STE. 100 KNOXVILLE TN 37950 1 0 0 0 Common stock 2004-05-20 4 A 0 508.0000 22.7500 A 55594.0000 D Common stock 4500.0000 I By Grandchildren's Trust Common stock 4506.0000 I By Gastrointestinal Associates, P.C., which Dr. Overholt is President Shares issued pursuant to the AmSurg Corp. 1997 Stock Incentive Plan and subject to 2 year vesting. Shares have been adjusted to reflect the 3-for-2 stock split effected in March 2004. /s/ Bergein F. Overholt, M.D. 2004-05-21 -----END PRIVACY-ENHANCED MESSAGE-----