Provider Demographics
NPI:1063666295
Name:FORSYTH MEMORIAL HOSPITAL, INC.
Entity Type:Organization
Organization Name:FORSYTH MEMORIAL HOSPITAL, INC.
Other - Org Name:UROLOGY PARTNERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR.VP OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:T
Authorized Official - Last Name:LINDSAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-718-2056
Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:704-716-4820
Mailing Address - Fax:
Practice Address - Street 1:121 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:ADVANCE
Practice Address - State:NC
Practice Address - Zip Code:27006-6651
Practice Address - Country:US
Practice Address - Phone:336-277-1717
Practice Address - Fax:336-277-1718
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOVANT MEDICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-14
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty