Healthcare Provider Details

I. General information

NPI: 1598237828
Provider Name (Legal Business Name): ORTHOPEDIC SURGICAL PARTNERS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2018
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 FOUNDERS ST STE 202
WILLIMANTIC CT
06226-2052
US

IV. Provider business mailing address

1111 CROMWELL AVE STE 403
ROCKY HILL CT
06067-3454
US

V. Phone/Fax

Practice location:
  • Phone: 860-525-4469
  • Fax: 860-450-7323
Mailing address:
  • Phone: 860-525-4469
  • Fax: 860-999-9305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ROBERT W MCALLISTER
Title or Position: PRESIDENT
Credential: MD
Phone: 860-525-4469