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Individual

DR. JAY MARTIN MACGREGOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11850 BLACKFOOT ST NW STE 130, COON RAPIDS, MN 55433-2583
(763) 236-9000
(763) 236-9010
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-9000

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
RL10279
ND
208C00000X
Colon & Rectal Surgery Physician
Primary
61311
MN
208C00000X
Colon & Rectal Surgery Physician
PT12950
ND
390200000X
Student in an Organized Health Care Education/Training Program
ME109661
FL

Other

Enumeration date
06/26/2008
Last updated
06/20/2024
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