Providence Family & Sports Medicine, Inc

LBN: Providence Family & Sports Medicine, Inc
Providence Family & Sports Medicine, Inc is an health care organization with primary practice located at 173 Executive Dr , Danville VA 24541-4101. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Providence Family & Sports Medicine, Inc can be contacted via phone (434) 791-4110, or through Wood, Lisa Campbell via phone (434) 791-4110.

Contact Information

Primary practice address
173 Executive Dr Danville VA 24541-4101
Phone: (434) 791-4110
Fax: (434) 791-4003
Website:
Map and Directions
Authorized official contact:
Name: Wood, Lisa Campbell
Phone: (434) 791-4110

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1053403378
LBN Legal business name Providence Family & Sports Medicine, Inc
DBA Doing business as
Authorized official Wood, Lisa Campbell
Entity Organization
Organization subpart 1 No
Enumeration date Sep 28th, 2006
Last updated May 26th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053403378 NPPES
Other 1053403378 NPI

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