Healthcare Provider Details

I. General information

NPI: 1881717833
Provider Name (Legal Business Name): JEANNE M MCGREGOR MD MPH PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 11/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 THONOTOSASSA RD
PLANT CITY FL
33563-4251
US

IV. Provider business mailing address

1605 THONOTOSASSA RD
PLANT CITY FL
33563-4251
US

V. Phone/Fax

Practice location:
  • Phone: 813-707-0200
  • Fax: 813-717-7701
Mailing address:
  • Phone: 813-707-0200
  • Fax: 813-717-7701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License NumberME53684
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberME53684
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME53684
License Number StateFL

VIII. Authorized Official

Name: DR. JEANNE M MCGREGOR
Title or Position: PRESIDENT/PHYSICIAN
Credential: M.D., M.P.H.
Phone: 813-707-0200