Organization
PARK PLACE PSYCHIATRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID D. SCHAFTER D.O., PH.D. (OWNER)
(334) 356-1417
Entity
Organization
Contact information
Practice address
207 WINTON M. BLOUNT LOOP, MONTGOMERY, AL 36117
(334) 356-1417
(334) 356-1433
Mailing address
P.O. BOX 241486, MONTGOMERY, AL 36124-1486
(334) 356-1417
(334) 356-1433
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2914
AL
101YP2500X
Professional Counselor
1452
AL
101YP2500X
Professional Counselor
2914
AL
2084P0800X
Psychiatry Physician
Primary
D0421
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529906980
—
AL
Enumeration date
03/06/2007
Last updated
06/14/2013
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