Provider Demographics
NPI:1255314282
Name:GREGG, SPENCER DUNCAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:DUNCAN
Last Name:GREGG
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 1:1800 VOLUNTEER BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37996-3102
Mailing Address - Country:US
Mailing Address - Phone:865-974-5222
Mailing Address - Fax:865-974-5260
Practice Address - Street 1:1800 VOLUNTEER BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37996-3102
Practice Address - Country:US
Practice Address - Phone:865-974-5222
Practice Address - Fax:865-974-5260
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD021058207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNG44074Medicare UPIN