Provider Demographics
NPI:1184999757
Name:MCGREGOR MEDICAL, LLC
Entity type:Organization
Organization Name:MCGREGOR MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MCGREGOR
Authorized Official - Suffix:
Authorized Official - Credentials:APRN- NP
Authorized Official - Phone:985-795-3336
Mailing Address - Street 1:6763 HIGHWAY 10
Mailing Address - Street 2:PO BOX 208
Mailing Address - City:GREENSBURG
Mailing Address - State:LA
Mailing Address - Zip Code:70441
Mailing Address - Country:US
Mailing Address - Phone:225-222-3401
Mailing Address - Fax:225-222-0022
Practice Address - Street 1:6763 HIGHWAY 10
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:LA
Practice Address - Zip Code:70441
Practice Address - Country:US
Practice Address - Phone:225-222-3401
Practice Address - Fax:225-222-0022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-15
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR890078363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty