Clifford Lee Thacker, MD - Family Medicine in Fort Myers, FL

Clifford Lee Thacker, MD is a Family Medicine - Addiction Medicine physician based in Fort Myers, Florida. Clifford Lee Thacker is licensed to practice in Florida (license number ME70754) and his current practice location is 12550 New Brittany Blvd Ste 201, Fort Myers, Florida. He can be reached at his office (for appointments etc.) via phone at (239) 343-9190.

NPI number for Clifford Lee Thacker is 1396731857 and his current mailing address is Po Box 2147, Fort Myers, Florida. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1396731857.

Contact Information

Clifford Lee Thacker, MD
12550 New Brittany Blvd Ste 201,
Fort Myers, FL 33907
(239) 343-9190
(239) 343-9193

Map and Direction




Physician's Profile

Full NameClifford Lee Thacker
GenderMale
SpecialityFamily Medicine - Addiction Medicine
Location12550 New Brittany Blvd Ste 201, Fort Myers, Florida
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1396731857
  • Provider Enumeration Date: 09/21/2005
  • Last Update Date: 07/21/2022

Medical Identifiers

Medical identifiers for Clifford Lee Thacker such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1396731857NPI-NPPES
101588900MedicaidFL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine ME70754 (Florida)Secondary
207V00000XObstetrics & Gynecology ME0070754 (Florida)Secondary
2084P0800XPsychiatry & Neurology - Psychiatry ME70754 (Florida)Secondary
207QA0401XFamily Medicine - Addiction Medicine ME70754 (Florida)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Clifford Lee Thacker is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Clifford Lee Thacker, MD
Po Box 2147,
Fort Myers, FL 33902-2147

Ph: (239) 343-9190
Clifford Lee Thacker, MD
12550 New Brittany Blvd Ste 201,
Fort Myers, FL 33907

Ph: (239) 343-9190

Reviews and Comments


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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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