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General NPI Number Information
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NPI Number | 1598621542
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Entity Type | Individual
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Provider Name | BENJAMIN FORT
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Gender | Male
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Dates
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Enumeration Date | 01/02/2026
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 410 W 10TH AVE
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City | COLUMBUS
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State | OH
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Zip | 43210-1240
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Country | US
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Telephone | 614-814-6503
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Fax | 614-293-0287
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Provider Business Mailing Address
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Address Line | 48 MIRROR LAKE RD
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City | THORNTON
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State | NH
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Zip | 03285-6135
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Country | US
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Telephone | 603-960-0616
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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