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
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000S02059
CSMS-IPA
CT
05
—
004139350
—
CT
01
—
50CONNSURCT01
ANTHEM BCBS
CT
01
—
87090
AETNA
CT
05
—
9781188
—
MA
01
—
G384943
OXFORD
CT
Enumeration date
11/15/2006
Last updated
03/02/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us