Provider Demographics
NPI:1043521222
Name:MCGREGOR, JAY MICHAEL (NP-C)
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:MICHAEL
Last Name:MCGREGOR
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 208
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:LA
Mailing Address - Zip Code:70441-0208
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:70441-3930
Practice Address - Country:US
Practice Address - Phone:225-222-3401
Practice Address - Fax:225-222-0022
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN102334 AND AP06140363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily