Thacker, Robert E.

Thacker, Robert E. is an individual health care provider with primary practice located at 620 10Th Street N. , St Petersburg FL 33705-1407. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pulmonary Disease, which is considered as his primary health care specialty. Thacker, Robert E. can be contacted via phone (727) 824-7144.

Contact Information

Primary practice address
620 10Th Street N. St Petersburg FL 33705-1407
Fax: (727) 824-8292
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X ME38522 Florida

Profile Details

NPI number 1881680973
LBN Legal business name Thacker, Robert E.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2005
Last updated Jul 14th, 2014 - about 11 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 1881680973 NPPES
Florida MEDICAID 065477900

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