Individual
PAUL G THACKER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MHA
Contact information
Practice address
200 FIRST STREET SW, ROCHESTER, MN 55905
(507) 284-2511
Mailing address
200 FIRST STREET SW, ROCHESTER, MN 55905
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
50171
MN
Other
Enumeration date
05/24/2007
Last updated
08/20/2020
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