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
85 SEYMOUR ST, STE 409, HARTFORD, CT 06106
(860) 547-0616
(860) 524-2655
Mailing address
17 TALCOTT NOTCH RD, FARMINGTON, CT 06032-1818
(860) 547-0616
(860) 524-2655
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000S02059
HEALTH NET VENDOR #
CT
05
—
004169711
—
CT
05
—
004201034
—
CT
05
—
01926310
—
NY
01
—
50CONNSURCT01
ANTHEM BCBS
CT
01
—
87090
AETNA
CT
05
—
9781188
—
MA
Enumeration date
11/30/2005
Last updated
08/11/2010
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up