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General NPI Number Information
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NPI Number | 1952659419
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Entity Type | Organization
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Legal Business Name | HORIZON HEALTHCARE LLC
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 02/25/2021
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Provider Practice Location Address
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Address Line | 205 GRAND AVE NW STE A
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City | FORT PAYNE
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State | AL
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Zip | 35967-2107
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Country | US
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Telephone | 256-635-6600
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Fax | 256-635-6601
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Provider Business Mailing Address
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Address Line | 205 GRAND AVE NW STE A
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City | FORT PAYNE
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State | AL
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Zip | 35967-2107
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Country | US
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Telephone | 256-635-6600
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Fax | 256-635-6601
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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 | M.D.
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Telephone | 256-635-6600
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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 | 16386
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License Number State | AL
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