Individual
CHRISTOPHER THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
818 N EMPORIA ST STE 200, WICHITA, KS 67214-3726
(316) 263-0296
Mailing address
551 N HILLSIDE ST STE 201, WICHITA, KS 67214-4925
(316) 263-0296
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
04-51053
KS
2086S0127X
Trauma Surgery Physician
Primary
04-51053
KS
Other
Enumeration date
03/18/2019
Last updated
10/09/2025
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