Provider Demographics
NPI:1790742609
Name:MCGREGOR, AMY L (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:L
Last Name:MCGREGOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:850 POPLAR AVE BLDG 2
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38105-4607
Mailing Address - Country:US
Mailing Address - Phone:901-287-5674
Mailing Address - Fax:901-287-6804
Practice Address - Street 1:848 ADAMS AVE
Practice Address - Street 2:SUITE L400
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-2816
Practice Address - Country:US
Practice Address - Phone:901-448-7642
Practice Address - Fax:901-448-8015
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN398042084N0402X, 2084E0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsy
No2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3329810Medicaid
TN3329810Medicaid
3329810Medicare ID - Type Unspecified