THACKER & THOMPSON NPI 1366595118

NPI Information

  • NPI: 1366595118
  • Provider Name: THACKER & THOMPSON
  • Classification: Clinic/Center - 261QM1300X
  • Specialization: Multi-Specialty
  • Entity Type: Organization
  • Doing Business As: THACKER, THOMPSON & BERNARD
  • CLIA Number: 11D0721797
  • Address: 619 RANKIN ST NE
    ATLANTA, GA
    ZIP 30308
  • Phone: (404) 874-3102

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NPI Details

THACKER & THOMPSON is a multi-specialty clinic center in Atlanta, GA. THACKER & THOMPSON NPI is 1366595118. The provider is registered as an organization entity type.
The provider Is Doing Business As Thacker, Thompson & Bernard.

The provider's business location address is:

619 RANKIN ST NE
ATLANTA, GA
ZIP 30308-920
Phone: (404) 874-3102
Fax: (404) 874-4817

The provider's authorized official is Sheryl Vernon Thacker .
The authorized official title is Manager and has the following contact phone number (404) 874-3102.

The CLIA number assigned to this NPI record is 11D0721797 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/18/2007 and was last updated on 1/26/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM1300XClinic/CenterMulti-SpecialtyGA024356GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1GRP1183MEDICARE PINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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