Doctor Name: | DR. JEREMY WAYNE THACKER |
NPI Number: | 1003026295 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 41747 |
Business Practice Address: | 800 Rose St Hx-302 Ukmc Lexington, KY - 405360293 |
Business Phone Number: | 8592574457 |
Business Fax Number: | |
Mailing Address: | 800 Rose St, Hx316 LEXINGTON |
State: | KY |
Postal Code: | 405360293 |
Phone Number: | 8599487773 |
Fax Number: | |
NPI Enumeration Date: | 05/23/2007 |
NPI Last Update Date: | 08/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | 41747 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |