Provider Demographics
NPI:1952334930
Name:MCGREGOR, ANDREW CRAIG (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:CRAIG
Last Name:MCGREGOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 STARLING ST STE 602
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-4271
Mailing Address - Country:US
Mailing Address - Phone:912-265-1300
Mailing Address - Fax:912-265-3580
Practice Address - Street 1:2500 STARLING ST STE 602
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4271
Practice Address - Country:US
Practice Address - Phone:912-265-1300
Practice Address - Fax:912-265-3580
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39313208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64102197Medicaid
KY4000501OtherMEDICARE LAB GROUP
KYASC1019OtherMEDICARE ASC GROUP
KY37903705OtherMEDICAID LAB GROUP
CB5773OtherRR MEDICARE GROUP
KY36000818OtherMEDICAID ASC GROUP
P00241289OtherRR MEDICARE PIN
KY36000818OtherMEDICAID ASC GROUP
P00241289OtherRR MEDICARE PIN