Provider Demographics
NPI:1043228851
Name:DR. MCGREGOR AND ASSOCIATES PA
Entity Type:Organization
Organization Name:DR. MCGREGOR AND ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:LEAANN
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-288-7445
Mailing Address - Street 1:1609 WOODRUFF RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-5928
Mailing Address - Country:US
Mailing Address - Phone:864-288-7445
Mailing Address - Fax:864-288-8288
Practice Address - Street 1:1609 WOODRUFF RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5928
Practice Address - Country:US
Practice Address - Phone:864-288-7445
Practice Address - Fax:864-288-8288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC682152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDA9930Medicaid
SC0638200001Medicare NSC
SC7202Medicare PIN