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NPI Code Detail

MEDICARE: FORSYTH MEDICAL GROUP LLC

MEDICARE: FORSYTH MEDICAL GROUP LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician

General Provider Information

NPI Number : 1295681666
Entity Type Code : Organization
Provider Name (Legal Business Name) : FORSYTH MEDICAL GROUP LLC
Provider Business Mailing Address
First Line : 2085 FRONTIS PLAZA BLVD FL 3
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27103-5614
Country : US
Telephone Number : 336-277-1611
Fax Number :
Provider Business Practice Location Address
First Line : 1311 WESTBROOK PLAZA DR STE 104
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27103-1327
Country : US
Telephone Number : 336-999-3125
Fax Number : 336-967-4127
Authorized Official
Title or Position : VP NETWORK DEVELOPMENT
Name : JODY GLENN MORRIS
Credential :
Telephone Number : 919-497-8401
Provider Enumeration Date : 03/09/2026
Last Update Date : 04/09/2026

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Directions to “FORSYTH MEDICAL GROUP LLC ” Practice Location

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