Fort, Glenn G.

Fort, Glenn G. is an individual health care provider with primary practice located at 115 Cass Ave Landmark Medical Center, Woonsocket RI 02895. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Fort, Glenn G. can be contacted via phone (401) 766-3428.

Contact Information

Primary practice address
115 Cass Ave Landmark Medical Center Woonsocket RI 02895
Phone: (401) 766-3428
Fax: (401) 767-1633
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD07281 Rhode Island

Profile Details

NPI number 1114900024
LBN Legal business name Fort, Glenn G.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 23rd, 2005
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114900024 NPPES
Rhode Island MEDICAID 9006604

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