Organization
MUHAMMAD EJAZ ATA
Active
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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