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1598852600

NPI Code Detail

MEDICARE: PHILIP J KREGOR MD

MEDICARE: PHILIP J KREGOR MD

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
1	207XX0801X	Orthopaedic Trauma Physician	75226	MN
2	207XX0801X	Orthopaedic Trauma Physician	MD.33955	AL
3	207X00000X	Orthopaedic Surgery Physician	036175835	IL
4	207XX0801X	Orthopaedic Trauma Physician	MD36107	TN
5	2086S0127X	Trauma Surgery Physician	MD36107	TN
6	207X00000X	Orthopaedic Surgery Physician	75226	MN

General Provider Information

NPI Number	:	1598852600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP J KREGOR MD

Provider Business Mailing Address
First Line	:	PO BOX 370
Second Line	:
City	:	FORTSON
State	:	GA
Zip	:	31808-0370
Country	:	US
Telephone Number	:	706-494-3171
Fax Number	:

Provider Business Practice Location Address
First Line	:	5875 E RIVERSIDE BLVD
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61114-4937
Country	:	US
Telephone Number	:	815-398-9491
Fax Number	:	815-381-7498

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2006
Last Update Date	:	01/28/2026

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Directions to “ PHILIP J KREGOR MD” Practice Location

Language	Start Address	Practice Location

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