| Thacker Family Medical, Pllc | |
|
189 Hibbard St Pikeville KY 41501-1754 | |
| (606) 432-0191 | |
| (606) 432-2028 |
| Full Name | Thacker Family Medical, Pllc |
|---|---|
| Speciality | General Practice |
| Location | 189 Hibbard St, Pikeville, Kentucky |
| Authorized Official Name and Position | Chadward L Thacker (OWNER) |
| Authorized Official Contact | 6064320191 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thacker Family Medical, Pllc 189 Hibbard St Pikeville KY 41501-1754 Ph: (606) 432-0191 | Thacker Family Medical, Pllc 189 Hibbard St Pikeville KY 41501-1754 Ph: (606) 432-0191 |
| NPI Number | 1841301520 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841301520 | NPI | - | NPPES |
| 64092638 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 38711 (Kentucky) | Primary |
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