Provider Demographics
NPI:1588904791
Name:HORIZON MEDICAL CLINIC LLC
Entity type:Organization
Organization Name:HORIZON MEDICAL CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:EJAZ
Authorized Official - Last Name:ATA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-599-7566
Mailing Address - Street 1:PO BOX 623
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:AL
Mailing Address - Zip Code:35121-0008
Mailing Address - Country:US
Mailing Address - Phone:205-625-3332
Mailing Address - Fax:
Practice Address - Street 1:2345 2ND AVE E STE B
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:AL
Practice Address - Zip Code:35121-2771
Practice Address - Country:US
Practice Address - Phone:205-625-3332
Practice Address - Fax:205-625-3342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-25
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty