DAVID THOMAS TACKETT

EDGEWOOD, KY
NPI1043821085
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: KY  1136773)
Enumeration Date2020-08-13
Last Update Date2020-08-13
Business Address
DAVID THOMAS TACKETT APRN
20 MEDICAL VILLAGE DR
EDGEWOOD, KY 41017-5401
Phone number: 859-578-5880
Mailing Address
DAVID THOMAS TACKETT APRN
PO BOX 635283
CINCINNATI, OH 45263-5283
Phone number: 859-578-5880
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