Provider Demographics
NPI:1255403929
Name:MACGREGOR, RODERICK HECTOR IAN (MD)
Entity type:Individual
Prefix:DR
First Name:RODERICK
Middle Name:HECTOR IAN
Last Name:MACGREGOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:332 CONGRESS PARK DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4133
Mailing Address - Country:US
Mailing Address - Phone:937-312-3627
Mailing Address - Fax:937-312-3719
Practice Address - Street 1:998 S DORSET RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-4753
Practice Address - Country:US
Practice Address - Phone:937-440-7766
Practice Address - Fax:937-440-8413
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350679722083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHC74401Medicare UPIN