Dr Ralph William Thacker Jr, DMD is a medicare enrolled "Dentist - General Practice" provider in Livermore, Kentucky. His current practice location is
222 Main St., Livermore, Kentucky. You can reach out to his office (for appointments etc.) via phone at
(270) 278-2385.
Dr Ralph William Thacker Jr is licensed to practice in Kentucky (license number 5649) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1770668162.
Healthcare Provider's Profile
| Full Name | Dr Ralph William Thacker Jr |
|---|
| Gender | Male |
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| Speciality | Dentist - General Practice |
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| Location | 222 Main St., Livermore, Kentucky |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1770668162
- Provider Enumeration Date: 10/26/2006
- Last Update Date: 04/24/2017
Medicare PECOS Information:
- PECOS PAC ID: 2961703103
- Enrollment ID: I20151222002264
Medical Identifiers
Medical identifiers for Dr Ralph William Thacker Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1770668162 | NPI | - | NPPES |
| 60056496 | Medicaid | KY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | 5649 (Kentucky) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Ralph William Thacker Jr is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Ralph William Thacker Jr, DMD
222 Main St., P.o Box 490,
Livermore, KY 42352-0490
Ph: (270) 278-2385 | Dr Ralph William Thacker Jr, DMD
222 Main St.,
Livermore, KY 42352-0490
Ph: (270) 278-2385 |
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