Organization
MUHAMMAD EJAZ ATA
Active
Other names
Scottsboro Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MUHAMMAD EJAZ ATA MD (MEDICAL DIRECTOR)
(256) 451-1250
Entity
Organization
Contact information
Practice address
506 HARLEY ST, SCOTTSBORO MEDICAL CLINIC, SCOTTSBORO, AL 35768-4219
(256) 574-6157
(256) 259-0560
Mailing address
PO BOX 246, PISGAH, AL 35765-0246
(256) 451-1250
(256) 451-1270
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013209
BLUE CROSS OF ALABAMA
AL
05
—
541003935
—
AL
01
—
CM0511
RAILROAD MEDICARE
—
Enumeration date
10/11/2006
Last updated
02/10/2009
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