# THACKER FAMILY MEDICAL, PLLC

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

## Provider details

- **NPI number:** 1841301520
- **Authorized official:** CHADWARD L THACKER MD (OWNER)
- **Authorized official phone:** (606) 432-0191

## Contact information

- **Practice address:** 189 HIBBARD ST, PIKEVILLE, KY 41501-1754
- **Practice address phone:** (606) 432-0191
- **Practice address fax:** (606) 432-2028
- **Mailing address:** 189 HIBBARD ST, PIKEVILLE, KY 41501-1754
- **Mailing address phone:** (606) 432-0191
- **Mailing address fax:** (606) 432-2028

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 38711 | KY | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 64092638 | — | KY |