Thacker, Dwight L

Thacker, Dwight L is an individual health care provider with primary practice located at 3650 W Rock Creek Rd #100, Norman OK 73072-2202. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Thacker, Dwight L can be contacted via phone (405) 701-3418.

Contact Information

Primary practice address
3650 W Rock Creek Rd #100 Norman OK 73072-2202
Phone: (405) 701-3418
Fax: (405) 701-3451
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R0073406 Oklahoma

Profile Details

NPI number 1801865100
LBN Legal business name Thacker, Dwight L
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2006
Last updated Apr 6th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801865100 NPPES
Oklahoma MEDICAID 200078370A

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