Organization
FORSYTH MEMORIAL HOSPITAL, INC
Active
Other names
Novant Health Kernersville 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
291 BROAD ST, KERNERSVILLE, NC 27284-2932
(336) 993-8181
(336) 996-9539
Mailing address
PO BOX 751803, CHARLOTTE, NC 28260-2362
(336) 993-8181
(336) 996-9539
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7901969
—
NC
01
—
CA1315
RAILROAD MEDICARE
NC
Enumeration date
05/02/2006
Last updated
07/11/2023
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