Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fayette Plasticsurgery Center LLC

Organization Ambulatory Surgical Clinic/Center · NPI 1639416365

Fayette Plasticsurgery Center LLC is an Ambulatory Surgical Clinic/Center in Fayetteville, Georgia. Licensed in Georgia. Registered with an NPI since 2013.

Licensed in
GA
In the registry since
2013
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

874 Lanier Ave W Ste 100
Fayetteville, GA 30214-7662
Phone: (770) 461-4000
Fax: (770) 603-7040
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ambulatory Surgical Clinic/Center (primary) Taxonomy 261QA1903X · Licence 12056659 (GA)

Record details

NPI number1639416365
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joseph Raniere — Vice President · (770) 461-4000
NPI enumeratedJanuary 15, 2013
Last updated in NPPESJanuary 15, 2013
Mailing address874 Lanier Ave W, Suite 100, Fayetteville, GA 30214-7662

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