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General NPI Number Information
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NPI Number | 1063948891
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Entity Type | Organization
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Legal Business Name | VALLEY MEDICAL CLINIC LLC
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 08/28/2017
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Provider Practice Location Address
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Address Line | 331 PARKS AVE
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City | SCOTTSBORO
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State | AL
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Zip | 35768-2411
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Country | US
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Telephone | 256-451-1250
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Fax | 256-451-1270
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Provider Business Mailing Address
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Address Line | PO BOX 56 331 PARKS AVENUE
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City | SCOTTSBORO
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State | AL
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Zip | 35768-0056
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Country | US
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Telephone | 256-451-1250
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Fax | 256-451-1270
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Authorized Official
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Title or Position | OWNER
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Name | MUHAMMAD E ATA
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Credential | MD
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Telephone | 256-451-1250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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