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NPI Code Detail

MEDICARE: LORAN COUTON MACGREGOR PHYSICIAN ASSISTANT

MEDICARE: LORAN COUTON MACGREGOR PHYSICIAN ASSISTANT
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
1363A00000XPhysician Assistant0110-004463VA

General Provider Information

NPI Number : 1497186217
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORAN COUTON MACGREGOR PHYSICIAN ASSISTANT
Provider Business Mailing Address
First Line : 234 CROOKED CREEK PKWY
Second Line :
City : DURHAM
State : NC
Zip : 27713-8505
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 234 CROOKED CREEK PKWY
Second Line :
City : DURHAM
State : NC
Zip : 27713-8505
Country : US
Telephone Number : 919-681-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2013
Last Update Date : 10/05/2025

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Directions to “ LORAN COUTON MACGREGOR PHYSICIAN ASSISTANT” Practice Location

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