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Organization

FORSYTH COMMUNITY PCC LLC

Active
Other names
Highland Avenue Primary Care Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization

Contact information

Practice address
650 HIGHLAND AVE STE 120, WINSTON SALEM, NC 27101-4304
(336) 718-4770
(336) 718-4779
Mailing address
PO BOX 603582, CHARLOTTE, NC 28260-3582

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
05/23/2018
Last updated
07/12/2023
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