Valley Head Clinic Llc | |
205 Grand Ave Nw Ste B Fort Payne AL 35967-2107 | |
(256) 979-1515 | |
(256) 979-1517 |
Full Name | Valley Head Clinic Llc |
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Speciality | Clinic/Center |
Location | 205 Grand Ave Nw, Fort Payne, Alabama |
Authorized Official Name and Position | Muhammad Ejaz Ata (OWNER) |
Authorized Official Contact | 2564511250 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Valley Head Clinic Llc 205 Grand Ave Nw Ste B Fort Payne AL 35967-2107 Ph: (256) 979-1515 | Valley Head Clinic Llc 205 Grand Ave Nw Ste B Fort Payne AL 35967-2107 Ph: (256) 979-1515 |
NPI Number | 1790004836 |
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Provider Enumeration Date | 05/28/2010 |
Last Update Date | 03/28/2017 |
Medicare PECOS PAC ID | 0941326888 |
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Medicare Enrollment ID | O20100928001066 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790004836 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 16386 (Alabama) | Primary |
Provider Name | Carolyn Brewer Stiefel |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609891456 PECOS PAC ID: 3779583406 Enrollment ID: I20070103000337 |
Provider Name | Cesar E Munoz |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1255432027 PECOS PAC ID: 7719067271 Enrollment ID: I20080109000592 |
Provider Name | Janna K Culpepper |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093866337 PECOS PAC ID: 0840353942 Enrollment ID: I20090115000689 |
Provider Name | Muhammad Ata |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1023112307 PECOS PAC ID: 5294631750 Enrollment ID: I20090429000389 |
Provider Name | Cathy Annette Olinger |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184764912 PECOS PAC ID: 1951368828 Enrollment ID: I20090430000097 |
Provider Name | Kimberly K Crow |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710120969 PECOS PAC ID: 6901956796 Enrollment ID: I20090617000344 |
Provider Name | Ashley W Thomas |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497027684 PECOS PAC ID: 5395904288 Enrollment ID: I20120313000411 |
Provider Name | Khizer Ahmad |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1689635161 PECOS PAC ID: 9739317637 Enrollment ID: I20140123001163 |
Provider Name | Jawahar Reddy Gazzala |
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Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1033373238 PECOS PAC ID: 3173830726 Enrollment ID: I20150915002872 |
Provider Name | Rachelle A Key |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508211509 PECOS PAC ID: 8022301068 Enrollment ID: I20160727003105 |
Provider Name | Anand Shanker Balachandran |
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Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1003187642 PECOS PAC ID: 4486948973 Enrollment ID: I20160805001323 |
Provider Name | Sean K Riggs |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689123051 PECOS PAC ID: 1951680578 Enrollment ID: I20161122000661 |
Provider Name | Josiah Keaton Aldrup |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184165748 PECOS PAC ID: 4587939350 Enrollment ID: I20171004000904 |
Provider Name | Bethany Lynne Johnson |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1841859287 PECOS PAC ID: 0244662195 Enrollment ID: I20220411000542 |
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