Provider Demographics
NPI:1225476146
Name:OAKLEY, JACKLYN M (MD)
Entity Type:Individual
Prefix:
First Name:JACKLYN
Middle Name:M
Last Name:OAKLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JACKLYN
Other - Middle Name:M
Other - Last Name:NEUMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-1510
Mailing Address - Country:US
Mailing Address - Phone:812-858-9400
Mailing Address - Fax:812-858-9571
Practice Address - Street 1:4015 GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8925
Practice Address - Country:US
Practice Address - Phone:812-858-9400
Practice Address - Fax:812-858-9571
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0174341A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine