# SOUTHERN OKLAHOMA LIFESTYLES AND PREVENTATIVE MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PARADIGM HORMONES, PLLC
- **Other names:** Paradigm Hormones
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1538673256
- **Legal business name:** PARADIGM HORMONES, PLLC
- **Authorized official:** NIKKI BUSELLATO (INS. CREDENTIALING)
- **Authorized official phone:** (405) 703-3614

## Contact information

- **Practice address:** 731 12TH AVE NW STE 201, ARDMORE, OK 73401-5764
- **Practice address phone:** (405) 703-3614
- **Mailing address:** 1301 S I 35 SERVICE RD STE 106, MOORE, OK 73160-3187
- **Mailing address phone:** (405) 703-3614

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | OK | Yes |

## Other

- **Enumeration date:** 11/17/2017
- **Last updated:** 11/17/2017