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General NPI Number Information
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NPI Number | 1689693970
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Entity Type | Organization
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Legal Business Name | CONNECTICUT EYE SURGERY CENTER SOUTH LLC
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 08/09/2022
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Provider Practice Location Address
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Address Line | 60 WELLINGTON RD
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City | MILFORD
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State | CT
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Zip | 06461-1677
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Country | US
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Telephone | 203-878-2010
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Fax | 203-877-2119
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Provider Business Mailing Address
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Address Line | 1A BURTON HILLS BLVD # L&C
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City | NASHVILLE
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State | TN
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Zip | 37215-6187
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Country | US
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Telephone | 615-240-3820
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Fax | 615-234-1720
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JEFFREY SNODGRASS
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Credential |
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Telephone | 615-665-1283
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number |
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License Number State |
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