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801 Poquonnock Rd Suite 6 Groton CT 06340-4564 | |
| (860) 405-1500 | |
| (800) 379-8041 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 801 Poquonnock Rd, Groton, Connecticut |
| Authorized Official Name and Position | Harold Eugene Phillips (OWNER) |
| Authorized Official Contact | 8604051500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
11 Wicklow Turn Ledyard CT 06339-1341 Ph: (860) 464-2871 | 801 Poquonnock Rd Suite 6 Groton CT 06340-4564 Ph: (860) 405-1500 |
| NPI Number | 1619254752 |
|---|---|
| Provider Enumeration Date | 11/03/2011 |
| Last Update Date | 11/03/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619254752 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 036959 (Connecticut) | Primary |
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