Most Relevant Information
Provider Data
| NPI Number: | 1114920261 |
| Provider Name: | RICHARD RANDALL THACKER D.O. |
| Entity Type: | Individual |
| Taxonomy Code: | 207R00000X |
| Specialty: | Internal Medicine |
| License Number: | MEOS6976 |
Most Important Dates
| Enumeration Date: | 05/23/2005 |
| Last Updated: | 08/20/2016 |
Provider Practice Location
2770 CAPITAL MEDICAL BLVD
STE 200
TALLAHASSEE
FL
323088417
Practice Location Phone/Fax
| Phone: | 8508788235 |
| Fax: | 8502192373 |
Provider Mailing Location
2770 CAPITAL MEDICAL BLVD
STE 200
TALLAHASSEE
FL
323088417
Provider Mailing Phone/Fax
| Phone: | 8508788235 |
| Fax: | 8502192373 |
Suggested EMR
Internist EMR