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General NPI Number Information
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NPI Number | 1326575994
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Entity Type | Organization
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Legal Business Name | FORSYTH PSYCHIATRIC ASSOCIATES, PLLC
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Dates
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Enumeration Date | 05/15/2017
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Last Update Date | 08/05/2017
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Provider Practice Location Address
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Address Line | 2554 LEWISVILLE CLEMMONS RD STE 209
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City | CLEMMONS
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State | NC
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Zip | 27012-8749
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Country | US
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Telephone | 336-660-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 2554 LEWISVILLE CLEMMONS RD, SUITE 209
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City | CLEMMONS
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State | NC
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Zip | 27012
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | WEIQING YUAN
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Credential |
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Telephone | 336-660-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2015-01825
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License Number State | NC
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