| Muhammad Ejaz Ata | |
|
6110 County Road 88 Pisgah Medical Clinic Pisgah AL 35765 | |
| (256) 451-1250 | |
| (256) 451-1270 |
| Full Name | Muhammad Ejaz Ata |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 6110 County Road 88, Pisgah, Alabama |
| Authorized Official Name and Position | Muhammad Ejaz Ata (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2564511250 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| 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 |
| NPI Number | 1306939467 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 02/10/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306939467 | NPI | - | NPPES |
| CM0511 | Other | AL | RAILROAD MEDICARE |
| 011432 | Other | BLUE CROSS OF ALABAMA | |
| 541003864 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Valley Head Clinic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6110 County Road 88, Pisgah, AL 35765 Phone: 256-451-1250 Fax: 256-451-1270 |