CLIFFORD LEE THACKER (MD) – Addiction Medicine (Family Medicine) Physician, NPI 1396731857

CLIFFORD LEE THACKER (MD) is a healthcare provider. based in Fort myers, Florida. specializing in Addiction Medicine (Family Medicine) Physician. They hold the professional credentials MD. They hold a License No. ME70754 (FL). The NPI Number for CLIFFORD LEE THACKER (MD) is 1396731857

Main info

Male
Name
CLIFFORD LEE THACKER (MD)
NPI
1396731857
Phone
(239) 343-9190
Address
PO BOX 2147
Enumeration Date
21 September 2005
Last Update Date
21 July 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience78
Completeness75
Years active:20State licenses:2Digital endpointsOther names

Provider Addresses for CLIFFORD LEE THACKER (MD)

  • Fort Myers Post Office, North Airport Road, Lee County, Florida, 33907, United States

    FORT MYERS, FL 339022147

    Phone: (239) 343-9190

    Fax: (239) 343-9193

    Type: Mailing

  • 9818 Old Hyde Park Pl

    Bradenton, FL 342024091

    Phone: (941) 556-9337

    Type: Location

  • 12550 New Brittany Blvd Ste 201

    Fort Myers, FL 33907

    Phone: (239) 343-9190

    Fax: (239) 343-9193

    Type: Location

  • 12550 NEW BRITTANY BLVD STE 201

    FORT MYERS, FL 33907

    Phone: (239) 343-9190

    Fax: (239) 343-9193

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

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No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33902)

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Frequently asked questions

Can I cross-check CLIFFORD LEE THACKER (MD) using NPI 1396731857?
NPI 1396731857 belongs to CLIFFORD LEE THACKER (MD); compare other details if you need extra assurance.
Is CLIFFORD LEE THACKER (MD) shown as active in public data?
Registry records indicate CLIFFORD LEE THACKER (MD) maintains an active NPI.
What clinical focus is listed for CLIFFORD LEE THACKER (MD)?
At a glance, CLIFFORD LEE THACKER (MD) is tied to Addiction Medicine (Family Medicine) Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for CLIFFORD LEE THACKER (MD)?
Travel planning: use Fort Myers, Florida as the reference point for CLIFFORD LEE THACKER (MD), then confirm.
When was this NPI issued?
Enumeration for CLIFFORD LEE THACKER (MD) is noted as September 21, 2005 where the registry provides it.

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