Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Providence Family & Sports Medicine, Inc

Organization Family Medicine Physician · NPI 1053403378

Providence Family & Sports Medicine, Inc is a Family Medicine Physician in Danville, Virginia. Works from 2 locations. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

173 Executive Dr
Danville, VA 24541-4101
Phone: (434) 791-4110
Fax: (434) 791-4003
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 441 Piney Forest Rd, Danville, VA 24540-4154 — (434) 791-4110

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1053403378
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lisa Wood — Office Manager · (434) 791-4110
NPI enumeratedSeptember 28, 2006
Last updated in NPPESMay 26, 2022
Certification dateMay 26, 2022
Mailing address173 Executive Dr, Danville, VA 24541-4101

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