Provider Demographics
NPI:1699776518
Name:SPIERS, KATHLEEN DELANEY (MD)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:DELANEY
Last Name:SPIERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 GROVE PARK CIR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-3115
Mailing Address - Country:US
Mailing Address - Phone:901-485-2810
Mailing Address - Fax:
Practice Address - Street 1:62 GROVE PARK CIR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-3115
Practice Address - Country:US
Practice Address - Phone:901-485-2810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS15248207RH0003X, 207RX0202X
ARE3136207RH0003X
TN21293207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00122446Medicaid
AR143968001Medicaid
6499045OtherCIGNA
TN0192197OtherBLUE CROSS BLUE SHIELD
TN3080792Medicaid
4598533OtherAETNA
AR5M183Medicare PIN
6499045OtherCIGNA
AR143968001Medicaid
4598533OtherAETNA
TN0192197OtherBLUE CROSS BLUE SHIELD
F74420Medicare UPIN