NPI Code Details Logo

NPI 1881559094

NPI 1881559094 : PATRICK COUNTY FAMILY PRACTICE PC : STUART, VA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1881559094
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    PATRICK COUNTY FAMILY PRACTICE PC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    12/19/2025
-----------------------------------------------------
    Last Update Date     |    12/19/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    835 WOODLAND DR 
-----------------------------------------------------
    City                 |    STUART
-----------------------------------------------------
    State                |    VA
-----------------------------------------------------
    Zip                  |    24171-1586
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    276-694-4466
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    835 WOODLAND DR 
-----------------------------------------------------
    City                 |    STUART
-----------------------------------------------------
    State                |    VA
-----------------------------------------------------
    Zip                  |    24171-1586
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OFFICE MANAGER
-----------------------------------------------------
    Name                 |     KATIE L SMITH 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    276-694-4466
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261QR1300X
-----------------------------------------------------
    Taxonomy Name        |    Rural Health Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.