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General NPI Number Information
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NPI Number | 1588904791
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Entity Type | Organization
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Legal Business Name | HORIZON MEDICAL CLINIC LLC
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Dates
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Enumeration Date | 02/25/2013
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Last Update Date | 03/05/2021
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Provider Practice Location Address
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Address Line | 2345 2ND AVE E STE B
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City | ONEONTA
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State | AL
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Zip | 35121-2771
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Country | US
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Telephone | 205-625-3332
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Fax | 205-625-3342
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Provider Business Mailing Address
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Address Line | PO BOX 623
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City | ONEONTA
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State | AL
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Zip | 35121-0008
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Country | US
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Telephone | 205-625-3332
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MUHAMMAD EJAZ ATA
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Credential | MD
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Telephone | 256-599-7566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State | AL
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