Organization
FAIRBURN SOUTHPARK MEDICAL AND SURGICAL CLINIC
Active
Organization
FAIRBURN SOUTHPARK MEDICAL AND SURGICAL CLINIC
Active
Other names
r.c.souza, md,pc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RENATO CHAVES SOUZA MD (PRESIDENT TREASURER)
(770) 964-9759
Entity
Organization
Contact information
Practice address
204 SENOIA RD, FAIRBURN, GA 30213-1536
(770) 964-9759
(770) 964-7001
Mailing address
204 SENOIA RD, FAIRBURN, GA 30213-1536
(770) 964-9759
(770) 964-7001
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
01/24/2007
Last updated
08/22/2020
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