Individual
DR. ROBERT E. THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
620 10TH STREET N., ST PETERSBURG, FL 33705-1407
(727) 824-7144
(727) 824-8292
Mailing address
PO BOX 12868, ST PETERSBURG, FL 33733-2868
(727) 532-1355
(727) 266-4928
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME38522
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065477900
—
FL
Enumeration date
09/23/2005
Last updated
07/14/2014
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