Provider Demographics
NPI:1861440067
Name:MONTCLAIR PSYCHIATRIC SERVICES PC
Entity Type:Organization
Organization Name:MONTCLAIR PSYCHIATRIC SERVICES PC
Other - Org Name:FRANK KAY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MADISON
Authorized Official - Middle Name:BATES
Authorized Official - Last Name:REDWINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-892-1900
Mailing Address - Street 1:860 MONTCLAIR RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-1923
Mailing Address - Country:US
Mailing Address - Phone:205-592-1900
Mailing Address - Fax:205-592-1965
Practice Address - Street 1:860 MONTCLAIR RD
Practice Address - Street 2:SUITE 160
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1923
Practice Address - Country:US
Practice Address - Phone:205-592-1900
Practice Address - Fax:205-592-1965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty