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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