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Organization
CONNECTICUT SURGICAL GROUP, PC
Active
Organization
CONNECTICUT SURGICAL GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS C. MCKELL (CHIEF ADMINISTRATIVE OFFICER)
(860) 524-4326
Entity
Organization
Contact information
Practice address
680 SOUTH MAIN STREET, LOWER LEVEL 2, CHESHIRE, CT 06410-3190
(203) 238-1241
(203) 686-0791
Mailing address
17 TALCOTT NOTCH RD, FARMINGTON, CT 06032-1818
(860) 524-2626
(860) 677-5029
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
NULL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
335E00000X
Prosthetic/Orthotic Supplier
—
NULL
Other
Enumeration date
11/15/2006
Last updated
03/02/2011
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