Charles Lee Lackey, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

12222 Issued in OK

Practice address

1515 N Porter Ave
Suite 200
Norman, OK 73071-6649

Phone

(405) 366-8619

NPI assigned

Nov 3, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Norman Endoscopy Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Norman, OK
  • NPI 1386892230
  NPD (past)
• Robert M. Holbrook MD, PLLC

  • Gastroenterology Physician
  • Norman, OK
  • NPI 1801824503
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1285625640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N PORTER AVE",
            "address_2": "SUITE 200",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716649",
            "telephone_number": "405-366-8619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N PORTER AVE",
            "address_2": "SUITE 200",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716649",
            "telephone_number": "405-366-8619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "CHARLES",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OK",
            "license": "12222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100106340A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dinah Bess L'Heureux, PA-C
• Joshua Kyle L'Hommedieu, PHARM.D
• Peter La, BA
• Bree Anna Labeth, DPT
• Krystalee Laboy
• Amanda Mae Lacroix, DO
• Jennifer Jean Ladd, LCSW
• Shannon Jenonne Ladd
• Grace Laden, COTA/L
• Natalie Laia

• Gastroenterology Physician in Norman, OK
• Providers in Norman, OK by specialty
• Gastroenterology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.