Healthcare Provider Details

I. General information

NPI: 1699714055
Provider Name (Legal Business Name): RONALD J SAXON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 05/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 NORTHWESTERN DR SUITE 300
BLOOMFIELD CT
06002-3444
US

IV. Provider business mailing address

4 NORTHWESTERN DR SUITE 300
BLOOMFIELD CT
06002-3444
US

V. Phone/Fax

Practice location:
  • Phone: 860-243-8997
  • Fax: 860-769-6803
Mailing address:
  • Phone: 860-243-8997
  • Fax: 860-769-6803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number16930
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: