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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
1260 SILAS DEANE HWY, WETHERSFIELD, CT 06109-4362
(860) 547-0614
(860) 524-2655
Mailing address
17 TALCOTT NOTCH RD, FARMINGTON, CT 06032-1818
(860) 947-0616
(860) 524-8643

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004139350
CT
01
50CONNSURCT01
ANTHEM BCBS
CT
Enumeration date
11/28/2005
Last updated
08/11/2010
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