Provider Demographics
NPI:1992087563
Name:MACGREGOR, MICHAEL SCOTT (PHARMD)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:SCOTT
Last Name:MACGREGOR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13704 CADORNA STRADA
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-5141
Mailing Address - Country:US
Mailing Address - Phone:405-496-8096
Mailing Address - Fax:
Practice Address - Street 1:13704 CADORNA STRADA
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-5141
Practice Address - Country:US
Practice Address - Phone:405-496-8096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14757183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist