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General NPI Number Information
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NPI Number | 1407669997
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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 | 01/29/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 7006 SHANNON WILLOW RD STE A
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City | CHARLOTTE
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State | NC
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Zip | 28226-1318
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Country | US
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Telephone | 980-960-0526
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Fax |
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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 | 336-277-8755
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Fax | 336-277-7701
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Authorized Official
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Title or Position | VP OPS & 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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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