Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Clifford Lee Thacker, MD

Individual provider Family Medicine Physician · NPI 1396731857

Clifford Lee Thacker, MD is a Family Medicine Physician in Fort Myers, Florida. Works from 3 locations. Licensed in Florida.

Licensed in
FL
In the registry since
2005
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

12550 New Brittany Blvd Ste 201
Fort Myers, FL 33907
Phone: (239) 343-9190
Fax: (239) 343-9193
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 9818 Old Hyde Park Pl, Bradenton, FL 34202-4091 — (941) 556-9337
  • 12550 New Brittany Blvd Ste 201, Fort Myers, FL 33907 — (239) 343-9190

Specialties & licences

Addiction Medicine (Family Medicine) Physician (primary) Taxonomy 207QA0401X · Licence ME70754 (FL)
Family Medicine Physician Taxonomy 207Q00000X · Licence ME70754 (FL)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence ME0070754 (FL)
Psychiatry Physician Taxonomy 2084P0800X · Licence ME70754 (FL)

Record details

NPI number1396731857
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 21, 2005
Last updated in NPPESJuly 21, 2022
Certification dateOctober 27, 2020
Mailing addressPo Box 2147, Fort Myers, FL 33902-2147

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