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NPI Code Detail

MEDICARE: THE MCGREGOR CLINIC, INC.

MEDICARE: THE MCGREGOR CLINIC, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1104092345
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE MCGREGOR CLINIC, INC.
Provider Business Mailing Address
First Line : 3487 BROADWAY AVENUE
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-7213
Country : US
Telephone Number : 239-334-9555
Fax Number : 239-334-2439
Provider Business Practice Location Address
First Line : 3487 BROADWAY AVENUE
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-7213
Country : US
Telephone Number : 239-334-9555
Fax Number : 239-334-2439
Authorized Official
Title or Position : CEO
Name : MR. BERT THOMAS HAMMOND
Credential :
Telephone Number : 239-334-9555
Provider Enumeration Date : 05/07/2008
Last Update Date : 01/20/2022

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Directions to “THE MCGREGOR CLINIC, INC. ” Practice Location

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