Organization
MUHAMMAD EJAZ ATA, M.D
Active
Other names
Pisgah Medical Clinic Scottsboro Medical Clinic Muhammad Ejaz Ata MD
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
207R00000X
Internal Medicine Physician
Primary
16386
AL
207R00000X
Internal Medicine Physician
24327
AL
207R00000X
Internal Medicine Physician
26901
AL
208000000X
Pediatrics Physician
24797
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529900820
—
AL
01
—
CM0511
RAILROAD MEDICARE
AL
Enumeration date
09/08/2006
Last updated
10/22/2009
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