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Individual

CURTIS THACKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5011
Mailing address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-1218

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
006250
AZ
207R00000X
Internal Medicine Physician
R2194
AZ
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
07/30/2012
Last updated
07/24/2017
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