John Lackey, MD
NPI 1063456648ActiveIndividual· Specialist· Pocatello, ID
Specialist (MD) in Pocatello, Idaho, trained at University of Missouri, Columbia School of Medicine (class of 1968). Part D covered 3,431 prescriptions written in 2024, 79% of them generic.
Overview
| NPI | 1063456648 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MD |
| Sole proprietor | No |
| NPI issued | Jun 15, 2006 |
| Last updated in NPPES | Jul 8, 2007 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist Primary | 174400000X | M3873 | ID |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Family Practice (ID); Practitioner - Obstetrics/Gynecology (TX) |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 3,431 · 3,506 30-day fills |
|---|---|
| Patients | 68 |
| Total drug cost | $172,001 |
| Generic share | 79% of claims |
Education and affiliations
| Medical school | University of Missouri, Columbia School of Medicine |
|---|---|
| Graduation year | 1968 |
| Medicare specialty | Obstetrics/Gynecology |
| Secondary specialties | General Practice |
| Telehealth | Offers telehealth |
Medical group
- Shoshone Bannock Tribes, IncFort Hall, ID · 2 clinicians
Hospital affiliation
- Portneuf Medical CenterPocatello, ID
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