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6110 County Road 88 Pisgah Medical Clinic Pisgah AL 35765 | |
(256) 451-1250 | |
(256) 451-1270 |
Full Name | |
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Speciality | Internal Medicine |
Location | 6110 County Road 88, Pisgah, Alabama |
Authorized Official Name and Position | Muhammad Ejaz Ata (MEDICAL DIRECTOR) |
Authorized Official Contact | 2564511250 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 246 6110 County Road 88 Pisgah AL 35765 Ph: (256) 451-1250 | 6110 County Road 88 Pisgah Medical Clinic Pisgah AL 35765 Ph: (256) 451-1250 |
NPI Number | 1851308910 |
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Provider Enumeration Date | 08/02/2006 |
Last Update Date | 10/22/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1851308910 | NPI | - | NPPES |
011432 | Other | AL | BLUE CROSS |
541003864 | Medicaid | AL | |
CM0511 | Other | RAILROAD MEDICACRE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 00000 (Maryland) | Primary |
208000000X | Pediatrics | 00000 (Michigan) | Secondary |