# FORSYTH MEMORIAL HOSPITAL INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Novant Health Surry Medical Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043690522
- **Authorized official:** GEOFFERY GARDNER (VP OF FINANCE)
- **Authorized official phone:** (336) 719-0398

## Contact information

- **Practice address:** 2133 ROCKFORD ST, SUITE 1400, MOUNT AIRY, NC 27030-6587
- **Practice address phone:** (336) 719-0398
- **Practice address fax:** (336) 719-0494
- **Mailing address:** PO BOX 751803, CHARLOTTE, NC 28275-1803
- **Mailing address phone:** (336) 719-0398

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 06/01/2015
- **Last updated:** 06/01/2015