| Muhammad Ejaz Ata, | |
|
6110 County Road 88, Pisgah Medical Clinic, Pisgah, AL 35765 | |
| (256) 451-1250 | |
| (256) 451-1270 |
| Full Name | Muhammad Ejaz Ata |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 39 Years |
| Location | 6110 County Road 88, Pisgah, Alabama |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023112307 | NPI | - | NPPES |
| 009910886 | Medicaid | AL | |
| 110061830 | Other | AL | RAILROAD MEDICARE |
| 051523907 | Other | AL | BLUE CROSS OF ALABAMA |
| 000087667 | Medicaid | AL | |
| 051087667 | Other | AL | BLUE CROSS OF ALABAMA |
| 529900820 | Medicaid | AL | |
| 541003864 | Medicaid | AL | |
| 541386401 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 16386 (Alabama) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Highlands Medical Center | Scottsboro, AL | Hospital |
| Marshall Medical Centers | Boaz, AL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Valley Head Clinic Llc | 0941326888 | 5 |
| Premier Medical Clinic Llc | 7012155609 | 4 |
| Entity Name | Valley Head Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790004836 PECOS PAC ID: 0941326888 Enrollment ID: O20100928001066 |
| Entity Name | Horizon Healthcare Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952659419 PECOS PAC ID: 2264682533 Enrollment ID: O20121022000688 |
| Entity Name | Midway Medical Clinic, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386984649 PECOS PAC ID: 4688819592 Enrollment ID: O20130326000041 |
| Entity Name | Horizon Medical Clinic, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588904791 PECOS PAC ID: 6406092972 Enrollment ID: O20130429000634 |
| Entity Name | Premier Medical Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083955173 PECOS PAC ID: 7012155609 Enrollment ID: O20130520000728 |
| Entity Name | American Drug Testing Lab Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1497197321 PECOS PAC ID: 6608005038 Enrollment ID: O20140206000545 |
| Entity Name | Med Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528467388 PECOS PAC ID: 9739496530 Enrollment ID: O20150910002074 |
| Entity Name | Valley Medical Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063948891 PECOS PAC ID: 0345512968 Enrollment ID: O20171023002583 |
| Mailing Address | Practice Location Address |
|---|---|
| Muhammad Ejaz Ata, Po Box 246, 6110 County Road 88, Pisgah, AL 35765-0246 Ph: (256) 451-1250 | Muhammad Ejaz Ata, 6110 County Road 88, Pisgah Medical Clinic, Pisgah, AL 35765 Ph: (256) 451-1250 |