| Valley Head Clinic LLC | |
|
205 Grand Ave Nw Ste B Fort Payne AL 35967-2107 | |
| (256) 979-1515 | |
| (256) 979-1517 |
| Full Name | Valley Head Clinic LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 205 Grand Ave Nw, Fort Payne, Alabama |
| Authorized Official Name and Position | Muhammad Ejaz Ata (OWNER) |
| Authorized Official Contact | 2564511250 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valley Head Clinic LLC 205 Grand Ave Nw Ste B Fort Payne AL 35967-2107 Ph: (256) 979-1515 | Valley Head Clinic LLC 205 Grand Ave Nw Ste B Fort Payne AL 35967-2107 Ph: (256) 979-1515 |
| NPI Number | 1790004836 |
|---|---|
| Provider Enumeration Date | 05/28/2010 |
| Last Update Date | 03/28/2017 |
| Medicare PECOS PAC ID | 0941326888 |
|---|---|
| Medicare Enrollment ID | O20100928001066 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790004836 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 16386 (Alabama) | Primary |
| Provider Name | Carolyn Brewer Stiefel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609891456 PECOS PAC ID: 3779583406 Enrollment ID: I20070103000337 |
| Provider Name | Cesar E Munoz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255432027 PECOS PAC ID: 7719067271 Enrollment ID: I20080109000592 |
| Provider Name | Muhammad Ata |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023112307 PECOS PAC ID: 5294631750 Enrollment ID: I20090429000389 |
| Provider Name | Cathy Annette Olinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184764912 PECOS PAC ID: 1951368828 Enrollment ID: I20090430000097 |
| Provider Name | Kimberly K Crow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710120969 PECOS PAC ID: 6901956796 Enrollment ID: I20090617000344 |
| Provider Name | Ashley W Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497027684 PECOS PAC ID: 5395904288 Enrollment ID: I20120313000411 |
| Provider Name | Khizer Ahmad |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689635161 PECOS PAC ID: 9739317637 Enrollment ID: I20140123001163 |
| Provider Name | Jawahar Reddy Gazzala |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1033373238 PECOS PAC ID: 3173830726 Enrollment ID: I20150915002872 |
| Provider Name | Rachelle a Key |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508211509 PECOS PAC ID: 8022301068 Enrollment ID: I20160727003105 |
| Provider Name | Anand Shanker Balachandran |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1003187642 PECOS PAC ID: 4486948973 Enrollment ID: I20160805001323 |
| Provider Name | Josiah Keaton Aldrup |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184165748 PECOS PAC ID: 4587939350 Enrollment ID: I20171004000904 |
| Provider Name | Cameron Townsend Corte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083034888 PECOS PAC ID: 8123381563 Enrollment ID: I20190730002620 |
| Provider Name | Bethany Lynne Johnson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1841859287 PECOS PAC ID: 0244662195 Enrollment ID: I20220411000542 |
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Rainsville Family Practice LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 421 Medical Center Dr Sw, Fort Payne, AL 35968 Phone: 256-845-1401 Fax: 256-845-1402 |
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Northside Medical, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 211 Greenhill Blvd Nw, Fort Payne, AL 35967 Phone: 256-845-9355 |