# SOUTH REGIONAL SURGICAL SERVICES

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679090815
- **Authorized official:** ANTHONY ROBINSON CSA (PRESIDENT)
- **Authorized official phone:** (678) 662-8792

## Contact information

- **Practice address:** 145 FOREST HALL LN, FAYETTEVILLE, GA 30214-4025
- **Practice address phone:** (678) 662-8792
- **Mailing address:** 145 FOREST HALL LN, FAYETTEVILLE, GA 30214-4025

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 08/28/2017
- **Last updated:** 08/28/2017