NPI 1538673256

Southern Oklahoma Lifestyles and Preventative Medicine

Organisation Public Health & General Preventive Medicine Physician Ardmore, OK

Practice location

Address: 731 12th Ave NW STE 201, Ardmore, OK 73401-5764
Phone: (405) 703-3614
Mailing address: 1301 S I 35 Service Rd STE 106, Moore, OK 73160-3187

Authorised official

Name: Nikki Busellato
Title: Ins. Credentialing
Phone: (405) 703-3614

Registered specialties

Public Health & General Preventive Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2083P0901X

Other Preventive Medicine providers in Oklahoma →

Registry record

NPI: 1538673256
Entity type: Organization
NPI issued: 17 Nov 2017
Record last updated: 17 Nov 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.