Individual
DR. DAVE H. THACKER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7321 11TH ST, 75 MDG/SGOPC, HILL AFB, UT 84056-5012
(801) 777-6804
(801) 586-4018
Mailing address
5144 VILLAGE WOOD CT, WEST VALLEY CITY, UT 84120-4585
(801) 982-1528
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
340105-1205
UT
Other
Enumeration date
01/12/2006
Last updated
07/08/2007
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