Dr Richard Randall Thacker, DO | |
2770 Capital Medical Blvd, Ste 200, Tallahassee, FL 32308-8417 | |
(850) 878-8235 | |
(850) 219-2373 |
Full Name | Dr Richard Randall Thacker |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Location | 2770 Capital Medical Blvd, Tallahassee, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1114920261 | NPI | - | NPPES |
058464900 | Other | FL | MEDICAID GROUP |
57188 | Other | FL | INDIVIDUAL PROVIDER BCBS |
99039 | Other | FL | GROUP BCBS ID NUMBER |
37822101 | Medicaid | FL | |
P00625814 | Other | FL | MEDICARE RAILROAD |
1114920261 | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | MEOS6976 (Florida) | Primary |
Entity Name | Deerfield Beach Physician Services, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1366100364 PECOS PAC ID: 3274928270 Enrollment ID: O20220520002459 |
Mailing Address | Practice Location Address |
---|---|
Dr Richard Randall Thacker, DO 2770 Capital Medical Blvd, Ste 200, Tallahassee, FL 32308-8417 Ph: (850) 878-8235 | Dr Richard Randall Thacker, DO 2770 Capital Medical Blvd, Ste 200, Tallahassee, FL 32308-8417 Ph: (850) 878-8235 |
Nantara Durrani, MBBS Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2626 Capital Medical Blvd, Tallahassee, FL 32308 Phone: 850-325-5885 | |
Dr. Indhira Bisono Jimenez, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3900 Esplanade Way, Tallahassee, FL 32311 Phone: 850-431-3867 Fax: 850-431-7384 | |
Carey A Dellock, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2631 Centennial Blvd, Suite 200, Tallahassee, FL 32308 Phone: 850-656-7265 Fax: 850-702-0245 | |
Dr. Hari K. Kolli, M.B.B.S. (M.D.) Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2617 Mitcham Dr Ste 102, Tallahassee, FL 32308 Phone: 850-878-1171 Fax: 850-942-1291 | |
Dr. Terence J. Murphy, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 2770 Capital Medical Blvd, Suite 200, Tallahassee, FL 32308 Phone: 850-878-8235 Fax: 850-877-1480 | |
Frank Edward Gredler, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1300 Medical Dr, Tallahassee, FL 32308 Phone: 850-216-0100 Fax: 850-216-0191 | |
Gizatchew Ketsela, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2709 Killarney Way Ste 2, Tallahassee, FL 32309 Phone: 850-329-2872 Fax: 850-329-2882 |