| NPI | 1033697859 |
|---|---|
| Doing Business As | OLD OAK PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | CHRISTOFER JOHN FORT President 203-533-9436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 056411) |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2018-12-21 |