Derek Thacker, M.D.

Surgery Physician · Jackson, TN

Individual Active NPI

NPI number 1538570544

Practice location

395 Hospital Blvd
Jackson, TN 38305-2080
Phone
(731) 664-7395

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NPI record

NPI
1538570544
Entity type
Individual (Type 1)
Enumeration date
May 13, 2014
Last updated
March 11, 2021
Certified
March 11, 2021
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Surgery Physician Primary 208600000X 61910 TN
Student in an Organized Health Care Education/Training Program 390200000X — —

Mailing address

250 Fleets Island Dr
Memphis, TN 38103-9019
Phone
(256) 606-8372

Other practice locations (1)

  • 2500 N State St, Department of Surgery, Jackson, MS 39216-4500 · (601) 984-5101

About Dr. Thacker

Derek Thacker, M.D. is a healthcare provider registered in the NPI registry with the primary taxonomy Surgery Physician (code 208600000X). The practice location is 395 Hospital Blvd, Jackson, TN 38305-2080. The NPI number 1538570544 was assigned on May 13, 2014 and the record was last updated on March 11, 2021.

Dr. Thacker lists a license in the registry: #61910 (TN) for Surgery Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Derek Thacker, M.D.?

The NPI number is 1538570544.

What is the phone number of Dr. Thacker?

The phone number listed for the practice location is (731) 664-7395.

Where is Dr. Thacker located?

395 Hospital Blvd, Jackson, TN 38305-2080.

What is the taxonomy code for Dr. Thacker?

The primary taxonomy code is 208600000X – Surgery Physician; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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