Provider Demographics
NPI:1528478955
Name:BAPTIST HEALTH
Entity type:Organization
Organization Name:BAPTIST HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-202-2080
Mailing Address - Street 1:9601 BAPTIST HEALTH DRIVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205
Mailing Address - Country:US
Mailing Address - Phone:501-202-2080
Mailing Address - Fax:
Practice Address - Street 1:10 MONTGOMERY DR
Practice Address - Street 2:
Practice Address - City:CADDO VALLEY
Practice Address - State:AR
Practice Address - Zip Code:71923-8901
Practice Address - Country:US
Practice Address - Phone:870-245-2198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAPTIST HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-07
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health