# CONNECTICUT SURGICAL GROUP, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922170786
- **Authorized official:** DOUGLAS C. MCKELL (CHIEF ADMINISTRATIVE OFFICER)
- **Authorized official phone:** (860) 524-4326

## Contact information

- **Practice address:** 680 SOUTH MAIN STREET, LOWER LEVEL 2, CHESHIRE, CT 06410-3190
- **Practice address phone:** (203) 238-1241
- **Practice address fax:** (203) 686-0791
- **Mailing address:** 17 TALCOTT NOTCH RD, FARMINGTON, CT 06032-1818
- **Mailing address phone:** (860) 524-2626
- **Mailing address fax:** (860) 677-5029

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | — |

## Other

- **Enumeration date:** 11/15/2006
- **Last updated:** 03/02/2011