Most Relevant Information
Provider Data
| NPI Number: | 1003026295 |
| Provider Name: | JEREMY WAYNE THACKER M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 2085R0202X |
| Specialty: | Radiology |
| License Number: | 41747 |
Most Important Dates
| Enumeration Date: | 05/23/2007 |
| Last Updated: | 08/06/2015 |
Provider Practice Location
800 ROSE ST
HX-302 UKMC
LEXINGTON
KY
405360293
Practice Location Phone/Fax
| Phone: | 8592574457 |
| Fax: |
Provider Mailing Location
800 ROSE ST
HX316
LEXINGTON
KY
405360293
Provider Mailing Phone/Fax
| Phone: | 8599487773 |
| Fax: |