Individual
DR. ANTHONY WAYNE THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1540 SPRING VALLEY DRIVE, HUNTINGTON, WV 25704
(304) 429-6741
(304) 429-0262
Mailing address
1540 SPRING VALLEY DRIVE, HUNTINGTON, WV 25704
(304) 429-6741
(304) 429-0262
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17430
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001719401
BCBS
WV
05
—
0053746000
—
WV
01
—
080173694
TRAVLERS MEDICARE
WV
Enumeration date
10/17/2006
Last updated
02/24/2025
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