CLIFFORD L. THACKER MD – NPI #1396731857
Family Medicine
A family medicine physician who specializes in the diagnosis and treatment of addictions.
CLIFFORD THACKER is a physician located in FORT MYERS, FL. NPPES has assigned the NPI number 1396731857 to CLIFFORD THACKER on September 21, 2005. It is a Type-1 NPI, indicating this NPI number is associated with an individual. According to the NPI data, there are 2 additional location(s) assigned to this provider which are listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207QA0401X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine, specializing in Addiction Medicine
The NPI profile was previously updated about 4 years ago on Jul 21, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CLIFFORD THACKER below.
NPI Profile for
CLIFFORD L. THACKER
(more than 20 years ago)
FORT MYERS, FL 33907 Phone: (239) 343-9190 Fax: (239) 343-9193
2 Other location(s):
Bradenton, FL 34202-4091
Phone: (941) 556-9337
Fort Myers, FL 33907
Phone: (239) 343-9190
Fax: (239) 343-9193
FORT MYERS, FL 33902-2147 Phone: (239) 343-9190 Fax: (239) 343-9193
Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.
Identifiers for CLIFFORD THACKER
Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.
| Description | Issuer | State | Identifier |
|---|---|---|---|
| MEDICAID | FL | 101588900 |
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 207QA0401X - Family Medicine / Addiction Medicine (Primary) |
FL | ME70754 |
| 2084P0800X - Psychiatry & Neurology / Psychiatry |
FL | ME70754 |
| 207V00000X - Obstetrics & Gynecology |
FL | ME0070754 |
| 207Q00000X - Family Medicine |
FL | ME70754 |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.