Thacker, Anthony Wayne

Thacker, Anthony Wayne is an individual health care provider with primary practice located at 1155 Main St , Milton WV 25541-1217. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Thacker, Anthony Wayne can be contacted via phone (304) 743-8833.

Contact Information

Primary practice address
1155 Main St Milton WV 25541-1217
Phone: (304) 743-8833
Fax: (304) 743-8834
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 17430 West Virginia

Profile Details

NPI number 1750461190
LBN Legal business name Thacker, Anthony Wayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2006
Last updated Jul 27th, 2015 - 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 1750461190 NPPES
West Virginia Other 001719401 BCBS
West Virginia Other 080173694 BCBS
West Virginia MEDICAID 0053746000 BCBS

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