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General NPI Number Information
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NPI Number | 1831293117
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Entity Type | Organization
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Legal Business Name | MUHAMMAD EJAZ ATA, M.D
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Dates
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Enumeration Date | 09/08/2006
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Last Update Date | 10/22/2009
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Provider Practice Location Address
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Address Line | 506 HARLEY ST SCOTTSBORO MEDICAL CLINIC
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City | SCOTTSBORO
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State | AL
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Zip | 35768-4219
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Country | US
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Telephone | 256-574-6157
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Fax | 256-259-0560
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Provider Business Mailing Address
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Address Line | PO BOX 246
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City | PISGAH
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State | AL
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Zip | 35765-0246
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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 | MEDICAL DIRECTOR
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Name | MUHAMMAD EJAZ 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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 24327
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 26901
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 24797
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 16386
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License Number State | AL
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