Provider Demographics
NPI:1497456016
Name:FERENCZY, SPENCER ALEXANDER (PA-C)
Entity Type:Individual
Prefix:
First Name:SPENCER
Middle Name:ALEXANDER
Last Name:FERENCZY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 FORT LOUDON MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37772-5686
Mailing Address - Country:US
Mailing Address - Phone:865-271-6000
Mailing Address - Fax:
Practice Address - Street 1:550 FORT LOUDOUN MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37772-5686
Practice Address - Country:US
Practice Address - Phone:865-271-6000
Practice Address - Fax:865-271-6456
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5429363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant