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General NPI Number Information
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NPI Number | 1912711169
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Entity Type | Organization
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Legal Business Name | OAK STREET HEALTH PHYSICIAN GROUP OF DELAWARE LLC
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 800 W 4TH ST STE 501
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City | WILMINGTON
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State | DE
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Zip | 19801-2054
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Country | US
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Telephone | 302-295-4730
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Fax | 302-487-1689
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Provider Business Mailing Address
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Address Line | PO BOX 746763
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City | ATLANTA
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State | GA
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Zip | 30374-6763
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Country | US
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Telephone | 773-352-1515
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Fax | 312-929-0373
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Authorized Official
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Title or Position | CMO, OWNER
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Name | DR. TERRENCE D MORTON
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Credential | MD
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Telephone | 704-607-4835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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