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

Emergency Providers Group LLC

Organization Emergency Medicine Physician · NPI 1164711206

Emergency Providers Group LLC is an Emergency Medicine Physician in Fort Walton Beach, Florida. Registered with an NPI since 2011.

In the registry since
2011
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Phone: (850) 862-1111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X

Record details

NPI number1164711206
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Penkhus — Vice President · (615) 344-9551
NPI enumeratedMarch 29, 2011
Last updated in NPPESApril 29, 2011
Mailing addressPo Box 741630, Atlanta, GA 30374-1630

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