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General NPI Number Information
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NPI Number | 1912951179
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Entity Type | Organization
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Legal Business Name | JOHN L. FORSYTHE, M.D.P.A
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 06/26/2020
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Provider Practice Location Address
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Address Line | 2300 HIGHWAY 365 STE 230
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City | NEDERLAND
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State | TX
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Zip | 77627-6283
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Country | US
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Telephone | 409-722-0808
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Fax | 409-722-4422
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Provider Business Mailing Address
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Address Line | 2300 HIGHWAY 365 STE 230
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City | NEDERLAND
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State | TX
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Zip | 77627-6283
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Country | US
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Telephone | 409-722-0808
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Fax | 409-722-4422
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN L FORSYTHE
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Credential | MD
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Telephone | 409-749-7130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E9635
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License Number State | TX
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