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Individual

DR. DAVID LEO THACKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
6101 N. KEYSTONE AVE, INDIANAPOLIS, IN 46220-2488
(317) 454-7505
(317) 454-7515
Mailing address
6101 N. KEYSTONE AVE, INDIANAPOLIS, IN 46220-2488
(317) 454-7505
(317) 454-7515

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
0202206395
VA
183500000X
Pharmacist
RP0006855
WV
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
26023537A
IN

Other

Enumeration date
08/29/2012
Last updated
08/29/2012
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