# THACKER FAMILY MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629342985
- **Authorized official:** DR. CHADWARD L. THACKER M.D. (SOILE MEMBER/OWNER)
- **Authorized official phone:** (606) 509-2000

## Contact information

- **Practice address:** 140 ADAMS LN, SUITE 600-700, PIKEVILLE, KY 41501-3087
- **Practice address phone:** (606) 509-2000
- **Practice address fax:** (606) 509-2002
- **Mailing address:** PO BOX 1228, 140 ADAMS LANE, SUITE 600-700, PIKEVILLE, KY 41502-1228
- **Mailing address phone:** (606) 509-2000
- **Mailing address fax:** (606) 509-2002

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 38711 | KY | Yes |

## Other

- **Enumeration date:** 03/05/2012
- **Last updated:** 04/11/2017