CLIFFORD LEE THACKER MD
NPI 1396731857
Family Medicine in Fort Myers,


Quality Rating: 100 out of 100 score

NPI Status: Active since September 21, 2005

Contact Information

12550 New Brittany Blvd Ste 201
Fort Myers,
Post Code: 33907
Phone: (239) 343-9190
Fax: (239) 343-9193

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Clifford Lee Thacker Md in Fort Myers - Family Medicine

Clifford Lee Thacker Md is a Family Medicine in Fort Myers, . Clifford Lee Thacker Md practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Clifford Lee Thacker Md is 1396731857. The last update date is 2022-07-21.

Clifford Lee Thacker Md's current location address is 12550 New Brittany Blvd Ste 201, Fort Myers, . You can contact this provider via phone number (239) 343-9190 and fax number (239) 343-9193. The mailing address for Clifford Lee Thacker Md is 12550 New Brittany Blvd Ste 201, Fort Myers, . To know further, please read the information below!

About GREGORY MERRITT

NPI
1396731857
Provider Name
CLIFFORD LEE THACKER MD
Gender
Male
Entity Type
Individual
Location Address
12550 New Brittany Blvd Ste 201, Fort Myers,
Location Phone
(239) 343-9190
Location Fax
(239) 343-9193
Mailing Address
Po Box 2147, Fort Myers, Florida(FL)
Mailing Phone
239-343-9190
Mailing Fax
239-343-9193
Enumeration Date
2005-09-21
Last Update Date
2022-07-21
Code Navigator

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine, Addiction Medicine

Taxonomy Code
207QA0401X
Type
-
License No.
ME70754
License State
Florida (FL)
Taxonomy Description
-

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1 207Q00000X Family Medicine Physician

Family Medicine

ME70754 (Florida)
2 207V00000X Obstetrics & Gynecology Physician

Obstetrics & Gynecology

ME0070754 (Florida)
3 2084P0800X Psychiatry Physician

Psychiatry & Neurology, Psychiatry

ME70754 (Florida)

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
101588900 MEDICAID (05) Florida (FL)

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1396731857
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
231861432810
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. 231861432810
2 + 3 + 1 + 8 + 6 + 1 + 4 + 3 + 2 + 8 + 1 + 0 + 24 = 63
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 63 = 7 7

The NPI number 1396731857 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1114920261 RICHARD RANDALL THACKER
Individual
Internal Medicine 2770 CAPITAL MEDICAL BLVD
TALLAHASSEE, Florida (FL)
850-878-8235
1306849336 ERIC L TOWNSEND
Individual
Dentist, General Practice 105 SOLANA RD
PONTE VEDRA, Florida (FL)
904-285-7711
1326041476 RICHARD G SCHWARTZ
Individual
Plastic Surgery 1500 N DIXIE HWY
WEST PALM BEACH, Florida (FL)
561-833-4022
1295738243 MEDFUND LLC
HORIZON COLUMBUS LLC
Organization
Clinic/Center, Magnetic Resonance Imaging (MRI) 240 N WASHINGTON BLVD
SARASOTA, Florida (FL)
941-925-3490
1194728147 BADER PROSTHETICS & ORTHOTICS, INC
Organization
Prosthetic/Orthotic Supplier 125 CHAPMAN RD E
LUTZ, Florida (FL)
813-962-6100