Provider Demographics
NPI:1063436277
Name:MCGREGOR, JEANNE M (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:M
Last Name:MCGREGOR
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 THONOTOSASSA RD
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-4251
Mailing Address - Country:US
Mailing Address - Phone:813-707-0200
Mailing Address - Fax:813-717-7701
Practice Address - Street 1:1605 THONOTOSASSA RD
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-4251
Practice Address - Country:US
Practice Address - Phone:813-707-0200
Practice Address - Fax:813-717-7701
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME53684207Q00000X, 2083P0500X, 202C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical Examiner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL372692400Medicaid
FL08183ZOtherMEDICARE FL BC/BS
FL372692400Medicaid