Healthcare Provider Details

I. General information

NPI: 1881582369
Provider Name (Legal Business Name): BAPTIST MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2025
Last Update Date: 06/25/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 BAPTIST WAY STE 3A
PENSACOLA FL
32503-2274
US

IV. Provider business mailing address

PO BOX 732892
DALLAS TX
75373-2892
US

V. Phone/Fax

Practice location:
  • Phone: 448-227-6500
  • Fax:
Mailing address:
  • Phone: 850-475-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: SHARON CREECH
Title or Position: DELEGATED OFFICIAL
Credential:
Phone: 850-607-3882