Provider Demographics
NPI:1639149867
Name:MCCACHREN, S SPENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:S
Middle Name:SPENCE
Last Name:MCCACHREN
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 1:1915 WHITE AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916
Mailing Address - Country:US
Mailing Address - Phone:865-541-1720
Mailing Address - Fax:865-541-2640
Practice Address - Street 1:220 BMH CANCER CENTER
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37804
Practice Address - Country:US
Practice Address - Phone:865-977-1065
Practice Address - Fax:865-982-8538
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26117207RH0003X
NC27248207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3086683Medicaid
TN3086683Medicaid
3086685Medicare ID - Type Unspecified