Individual
DR. AMBER THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
877 JEFFERSON AVE, MEMPHIS, TN 38103-2807
(901) 545-7100
(901) 545-8996
Mailing address
1068 CRESTHAVEN RD STE 300, MEMPHIS, TN 38119-0809
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
57503
TN
208000000X
Pediatrics Physician
57503
TN
208M00000X
Hospitalist Physician
Primary
57503
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00002511
—
MS
05
—
1770903882
—
MO
05
—
230368001
—
AR
05
—
Q037020
—
TN
Enumeration date
04/16/2014
Last updated
02/25/2025
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