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Organization

HORIZON HEALTHCARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MUHAMMAD EJAZ ATA M.D. (OWNER)
(256) 635-6600
Entity
Organization

Contact information

Practice address
205 GRAND AVE NW STE A, FORT PAYNE, AL 35967-2107
(256) 635-6600
(256) 635-6601
Mailing address
205 GRAND AVE NW STE A, FORT PAYNE, AL 35967-2107
(256) 635-6600
(256) 635-6601

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
16386
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01-8902
MEDICARE ID
AL
Enumeration date
08/15/2012
Last updated
02/25/2021
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