Organization

Connecticut Surgical Group, Pc

Legal Business Name

Connecticut Surgical Group, Pc

NPI Number

1558344895

NPI Type

Organization

Enumeration Date

11/21/2005

Contact
Information

Purpose

Mailing
Location

Address

17 TALCOTT NOTCH RD
65 MEMORIAL RD

City

Farmington
West Hartford

State

CT
CT

Postal Code

06032-1818
06107-2434

Country

US
US

Telephone Number

(860) 547-0616
(860) 547-0616

Authorized Official

Name

Douglas Mckell

Title or Position

CHIEF ADMINISTRATIVE OFFICER

Telephone Number

(860) 524-4326

Identifiers

Identifier

004139350
9781188
004169711
004201034
50CONNSURCT01
01926310

Identifier State

CT
MA
CT
CT
CT
NY

Identifier Issuer

Unknown
Unknown
Unknown
Unknown
ANTHEM BCBS
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/11/2010

Provider Address