| Dr Christopher C Thacker, MD | |
|
400 Berywood Trl Nw, Suite B, Cleveland, TN 37312-5287 | |
| (423) 472-3201 | |
| (423) 476-4949 |
| Full Name | Dr Christopher C Thacker |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 30 Years |
| Location | 400 Berywood Trl Nw, Cleveland, Tennessee |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881658664 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | MD34911 (Tennessee) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Tennova Health Care-cleveland | Cleveland, TN | Hospital |
| Starr Regional Medical Center Athens | Athens, TN | Hospital |
| Memorial Healthcare System, Inc | Chattanooga, TN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Tennessee Valley Urology Center Pc | 2062538077 | 5 |
| Entity Name | Tennessee Valley Urology Center Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538173232 PECOS PAC ID: 2062538077 Enrollment ID: O20100928000567 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Christopher C Thacker, MD 400 Berywood Trl Nw, Suite B, Cleveland, TN 37312-5287 Ph: (423) 472-3201 | Dr Christopher C Thacker, MD 400 Berywood Trl Nw, Suite B, Cleveland, TN 37312-5287 Ph: (423) 472-3201 |
Daniel Box, Urology Medicare: Accepting Medicare Assignments Practice Location: 400 Berywood Trl Nw Ste B, Cleveland, TN 37312 Phone: 423-472-3201 Fax: 423-476-4949 | |
Edward M Mcintire Jr., M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 400 Berywood Trl Nw, Suite B, Cleveland, TN 37312 Phone: 423-472-3201 Fax: 423-476-4949 | |
Mr. Joseph Alexander Ivey Iii, Urology Medicare: Accepting Medicare Assignments Practice Location: 400 Berywood Trl Nw Ste B, Cleveland, TN 37312 Phone: 423-472-3201 Fax: 423-476-4949 | |
Dr. Stephen W Jackson, M.D. Urology Medicare: Medicare Enrolled Practice Location: 400 Berywood Trl Nw, Suite B, Cleveland, TN 37312 Phone: 423-472-3201 Fax: 423-476-4949 | |
Dr. Grant Pegram Simmons, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 400 Berywood Trl Nw Ste B, Cleveland, TN 37312 Phone: 423-472-3201 Fax: 423-476-4949 |