Organization
FORSYTH MEMORIAL HOSPITAL INC
Active
Other names
Novant Health Chair City Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
903 RANDOLPH ST, THOMASVILLE, NC 27360-5898
(336) 475-7163
(336) 475-1199
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(704) 384-7606
(336) 277-7722
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0151N
BLUECROSS BLUESHIELD
NC
01
—
603
BLUE MEDICARE
NC
05
—
89015YU
—
NC
01
—
CA1315
RAILROAD MEDICARE
NC
Enumeration date
05/02/2006
Last updated
07/10/2023
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