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General NPI Number Information
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NPI Number | 1396624078
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Entity Type | Organization
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Legal Business Name | FORSYTH MEDICAL GROUP LLC
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Dates
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Enumeration Date | 08/28/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 8924 BLAKENEY PROFESSIONAL DR
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City | CHARLOTTE
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State | NC
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Zip | 28277-6660
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Country | US
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Telephone | 704-703-1080
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Fax | 704-703-1090
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Provider Business Mailing Address
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Address Line | 2085 FRONTIS PLAZA BLVD FL 3
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City | WINSTON SALEM
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State | NC
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Zip | 27103-5614
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Country | US
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Telephone | 336-277-1611
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Fax |
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Authorized Official
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Title or Position | VP OPS AND NEW DEVELOPMENT
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Name | JODY MORRIS
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Credential |
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Telephone | 919-497-8401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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