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Organization

THACKER DERMATOLOGY LLC

Active
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Organization

THACKER DERMATOLOGY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BETSY PERRY THACKER (OWNER)
(229) 469-4383
Entity
Organization

Contact information

Practice address
4233 CAMELOT CROSSING, VALDOSTA, GA 31602
(229) 469-4383
(229) 469-4584
Mailing address
4233 CAMELOT CROSSING, VALDOSTA, GA 31602
(229) 469-4383
(229) 469-4584

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary

Other

Enumeration date
03/17/2011
Last updated
10/26/2023
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