DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

CLIFFORD LEE THACKER, MD

Active

CLIFFORD LEE THACKER, MD is a Addiction Medicine (Family Practice) healthcare provider located in FORT MYERS, Florida. NPI 1396731857 is currently active in the NPPES registry. Verify at CMS.

Addiction Medicine (Family Practice) · FORT MYERS, FL

Registration Details

NPI Number
1396731857
Provider Type
Individual
Gender
Male
NPI Issued
Sep 21, 2005 (20.917289503692 yrs)
Last Updated
Jul 21, 2022
Licenses
ME70754 (FL)
ME0070754 (FL)
ME70754 (FL)
ME70754 (FL)

Practice Information

Address
12550 NEW BRITTANY BLVD STE 201
FORT MYERS, FL, 33907
Browse FL providers · Browse ZIP 33907
Phone
2393439190
Fax
2393439193
Primary Specialty
Addiction Medicine (Family Practice)
207QA0401X
Additional Specialty
Obstetrics & Gynecology
Additional Specialty
Psychiatry

Other Addiction Medicine (Family Practice) Providers in FORT MYERS, FL

Name Credential NPI
DR. WASHINGTON DARIO BAQUERO MD 1962509521
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.