FAIRBURN SOUTHPARK MEDICAL AND SURGICAL CLINIC
NPI 1780739318
Clinic/Center in Fairburn, GA

Q: What is Fairburn Southpark Medical And Surgical Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Active since January 24, 2007

204 SENOIA RD, FAIRBURN, GA 30213(770) 964-9759(770) 964-7001 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Fairburn Southpark Medical And Surgical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAIRBURN SOUTHPARK MEDICAL AND SURGICAL CLINIC (NPI 1780739318), doing business as R.c.souza, Md,pc, is a healthcare organization registered as a clinic/center in Fairburn, Georgia and active in the NPI registry since January 2007. The organization lists Renato Chaves Souza, President Treasurer, as its authorized official.

NPPES Registry Identity

NPI1780739318

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NameFAIRBURN SOUTHPARK MEDICAL AND SURGICAL CLINIC

Location Address204 SENOIA RDFairburn, GA 30213-1536

Mailing Address204 Senoia RdFairburn, GA 30213-1536 · (770) 964-9759 · Fax (770) 964-7001

Phone(770) 964-9759

Fax(770) 964-7001

Organization SubpartNo

Authorized OfficialRenato Chaves SouzaPresident Treasurer · (770) 964-9759

Enumeration DateJanuary 24, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1780739318 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

204 SENOIA RD, Fairburn, GA 30213

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Other Names 1

Former Legal Business NameR.c.souza, Md,pc

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RENATO CHAVES SOUZA MD

Family Medicine

204 SENOIA RD
FAIRBURN, GA 30213

Fulton County (770) 964-9759

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fairburn Southpark Medical And Surgical Clinic's NPI number?

The NPI number for Fairburn Southpark Medical And Surgical Clinic is 1780739318. It was assigned to this organization in the NPPES registry on January 24, 2007. The provider was formerly known as R.C.Souza, Md,pc.

Where is Fairburn Southpark Medical And Surgical Clinic located?

Fairburn Southpark Medical And Surgical Clinic is located at 204 Senoia Rd, Fairburn, GA 30213. The listed phone number is (770) 964-9759.

What is Fairburn Southpark Medical And Surgical Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Fairburn Southpark Medical And Surgical Clinic was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.