Old Oak Primary Care, P.c.

NPI #1033697859 in Southbury, Connecticut

Provider Information

NPI Number: 1033697859
Entity Type: Organization
Organization Name: Old Oak Primary Care, P.c.
Primary Specialty: Internal Medicine
Enumeration Date: Aug 2, 2018
Last Updated: Dec 21, 2018

Practice Location

Address: 250 MAIN ST S UNIT G
City: Southbury
State: Connecticut
ZIP Code: 06488-2263
Phone: (203) 533-9436

Authorized Official

Name: DR. CHRISTOFER JOHN FORT, MD
Title: PRESIDENT
Phone: (203) 533-9436

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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