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General NPI Number Information
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NPI Number | 1144471236
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Entity Type | Organization
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Legal Business Name | PARADIGM HEALTHCARE
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Dates
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Enumeration Date | 10/07/2008
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Last Update Date | 12/02/2009
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Provider Practice Location Address
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Address Line | 2401 W WRANGLER BLVD
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City | SEMINOLE
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State | OK
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Zip | 74868-1917
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Country | US
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Telephone | 405-303-4186
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Fax | 405-303-4158
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Provider Business Mailing Address
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Address Line | PO BOX 1151
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City | SEMINOLE
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State | OK
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Zip | 74818-1151
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Country | US
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Telephone | 405-303-4186
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Fax | 405-303-4158
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Authorized Official
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Title or Position | OWNER
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Name | MARY KATHRYN MACHADO
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Credential | A.R.N.P.
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Telephone | 405-303-4186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 3631
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 24484
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 3189
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 2750
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License Number State | OK
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R0073365
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License Number State | OK
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