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Organization
THACKER FAMILY MEDICAL, PLLC
Active
Organization
THACKER FAMILY MEDICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHADWARD L THACKER MD (OWNER)
(606) 432-0191
Entity
Organization
Contact information
Practice address
189 HIBBARD ST, PIKEVILLE, KY 41501-1754
(606) 432-0191
(606) 432-2028
Mailing address
189 HIBBARD ST, PIKEVILLE, KY 41501-1754
(606) 432-0191
(606) 432-2028
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
38711
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64092638
—
KY
Enumeration date
08/31/2006
Last updated
08/22/2020
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