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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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LACKEY, JAMES MANNING       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: AXIS HEALTHCARE
23 W COMMERCIAL ST
INOLA OK 74036

Address last updated on 12/6/2023
Phone #: (918) 543-8880
Fax #:
County: ROGERS
License: 30999
Dated: 1/15/2015
Expires: 1/1/2025
License Type: Medical Doctor
Specialty: Family Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of TX Southwestern Med Sch At Dallas SW Med Sch, Dallas Tx 75235
Graduated: 6 / 2000
CME Year: 2027
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF FAMILY MEDICINE
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: Aetna Elect Choice
Aetna HMO
Aetna Managed Choice
Aetna PPO
Champ VA
CIGNA HMO
CIGNA PPO
CommunityCare HMO, Inc
CommunityCare Senior HMO
Coventry Health Care National Network
Humana ChoiceCare
Humana Medicare Advantage PPO
Humana Tricare/PGBA
Multiplan PPO
SoonerCare HMO
SoonerCare PPO
Tricare for Life
Tricare Standard
United Healthcare Choice
United Healthcare HMO
Hospital Privileges: None listed
Locations: Hours: Languages:
AXIS HEALTHCARE
23 W COMMERCIAL ST
INOLA OK 74036

Phone #: (918) 543-8880
Fax #:
Mon: 8:00AM - 5:00PM
Tue: 8:00AM - 5:00PM
Wed: 8:00AM - 5:00PM
Thu: 8:00AM - 5:00PM
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
JENNIFER ADAMS APRN 88899
ELIZABETH ALLEN APRN 15474
JULIE BROADDRICK APRN 118511
JULIA JONES APRN 10785
AUBREY MARIE MASSARO PA 5207
ASHLEY PAYNE APRN 5795

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