OrganizationActive
Southern Oklahoma Lifestyles and Preventative Medicine
NPI 1538673256 · Public Health & General Preventive Medicine Physician · Ardmore, OK
Provider details
- NPI number
- 1538673256
- Entity type
- Organization
- Primary specialty
- Public Health & General Preventive Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Paradigm Hormones, PLLC
- Organization subpart
- Yes
- Authorized official
- Nikki Busellato, Ins. Credentialing(405) 703-3614
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
731 12th Ave Nw Ste 201
Ardmore, OK 73401-5764
Phone: (405) 703-3614
Approximate (ZIP-level) locationGet directions
Mailing address
1301 S I 35 Service Rd Ste 106
Moore, OK 73160-3187
Other names (DBA / former)
- Doing business as
- Paradigm Hormones
Registry dates
- Enumerated
- 2017-11-17
- Last updated
- 2017-11-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.