Provider Demographics
NPI:1235217449
Name:MACGREGOR, JAMES BYRON (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BYRON
Last Name:MACGREGOR
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 PROLINE PL
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-9402
Mailing Address - Country:US
Mailing Address - Phone:717-337-3005
Mailing Address - Fax:717-337-3301
Practice Address - Street 1:1400 PROLINE PL
Practice Address - Street 2:SUITE 1000
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-9402
Practice Address - Country:US
Practice Address - Phone:717-337-3005
Practice Address - Fax:717-337-3301
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS009194L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001850000Medicaid
PAMA046192Medicare ID - Type Unspecified
PA001850000Medicaid