Provider Demographics
NPI:1518120088
Name:MCGREGOR, JONATHAN BROOKS (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:BROOKS
Last Name:MCGREGOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2507 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001
Mailing Address - Country:US
Mailing Address - Phone:270-442-8228
Mailing Address - Fax:
Practice Address - Street 1:2507 BROADWAY
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001
Practice Address - Country:US
Practice Address - Phone:270-442-8228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-05
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR1555207L00000X
KY44205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology