Fairburn Southpark Medical And Surgical Clinic

NPI 1780739318 - Clinic/Center - 261Q00000X

NPI Details
NPI 1780739318
Enumeration Date 01/24/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name RENATO CHAVES RENATO
Position PRESIDENT TREASURER
Phone (770) 964-9759
Fax (770) 964-7001
Practice Location
204 SENOIA RD
FAIRBURN GA, 30213-1536, US
Phone (770) 964-9759
Fax (770) 964-7001
Business Location
204 SENOIA RD
FAIRBURN GA, 30213-1536, US
Phone (770) 964-9759
Fax (770) 964-7001
Toxanomy
Taxonomy Code 261Q00000X
License State
License Number
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According to our database, Fairburn Southpark Medical And Surgical Clinic NPI is 1780739318, taxonomy code is 261Q00000X Fairburn Southpark Medical And Surgical Clinic physically located at 204 Senoia Rd, Fairburn GA, 30213-1536. NPI Number 1033115704 has the healthcare provider type.

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1780739318 NPI number is provided on an as is basis without warranty of any kind. 1780739318 is maintained by the National Plan & Provider Enumeration System. The contents of Fairburn Southpark Medical And Surgical Clinic are for informational purposes only.