Organization
BAPTIST PHYSICIAN GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON L CREECH (CREDENTIALS MANAGER)
(850) 475-3726
Entity
Organization
Contact information
Practice address
133 RACETRACK RD NW, FORT WALTON BEACH, FL 32547-1644
(850) 916-8700
Mailing address
PO BOX 30532, PENSACOLA, FL 32503-1532
(850) 475-3726
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
Other
Enumeration date
06/25/2019
Last updated
06/25/2019
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