Provider Demographics
NPI:1033554357
Name:SOUTHVIEW MEDICAL CLINIC LLC
Entity Type:Organization
Organization Name:SOUTHVIEW MEDICAL CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
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:256-451-1250
Mailing Address - Street 1:307 MAIN ST SW
Mailing Address - Street 2:
Mailing Address - City:HANCEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35077-5476
Mailing Address - Country:US
Mailing Address - Phone:256-352-4767
Mailing Address - Fax:256-352-4797
Practice Address - Street 1:307 MAIN ST SW
Practice Address - Street 2:
Practice Address - City:HANCEVILLE
Practice Address - State:AL
Practice Address - Zip Code:35077-5476
Practice Address - Country:US
Practice Address - Phone:256-352-4767
Practice Address - Fax:256-352-4797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-30
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health