Healthcare Provider Details

I. General information

NPI: 1881559094
Provider Name (Legal Business Name): PATRICK COUNTY FAMILY PRACTICE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 WOODLAND DR
STUART VA
24171-1586
US

IV. Provider business mailing address

835 WOODLAND DR
STUART VA
24171-1586
US

V. Phone/Fax

Practice location:
  • Phone: 276-694-4466
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATIE L SMITH
Title or Position: OFFICE MANAGER
Credential:
Phone: 276-694-4466