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Individual

DR. DALE MCGREGOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3131 S MAIN ST, MOULTRIE, GA 31768-6925
(229) 985-3420
Mailing address
PO BOX 40, MOULTRIE, GA 31776-0040
(229) 985-3420

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
025220
GA
207Q00000X
Family Medicine Physician
025220
GA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
025220
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000268815A
GA
05
000268815B
GA
01
202I195279
MEDICARE
GA
Enumeration date
08/22/2005
Last updated
05/29/2015
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