Organization
THACKER FAMILY MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHADWARD L. THACKER M.D. (SOILE MEMBER/OWNER)
(606) 509-2000
Entity
Organization
Contact information
Practice address
140 ADAMS LN, SUITE 600-700, PIKEVILLE, KY 41501-3087
(606) 509-2000
(606) 509-2002
Mailing address
PO BOX 1228, 140 ADAMS LANE, SUITE 600-700, PIKEVILLE, KY 41502-1228
(606) 509-2000
(606) 509-2002
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38711
KY
Other
Enumeration date
03/05/2012
Last updated
04/11/2017
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