| Impact Physician Group, Llc | |
|
5825 Harrison Blvd South Ogden UT 84403-4316 | |
| (801) 475-5254 | |
| Not Available |
| Full Name | Impact Physician Group, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5825 Harrison Blvd, South Ogden, Utah |
| Authorized Official Name and Position | Paul Miller (CEO) |
| Authorized Official Contact | 6789675599 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Physician Group, Llc Po Box 744577 Atlanta GA 30374-4577 Ph: () - | Impact Physician Group, Llc 5825 Harrison Blvd South Ogden UT 84403-4316 Ph: (801) 475-5254 |
| NPI Number | 1366262487 |
|---|---|
| Provider Enumeration Date | 10/14/2024 |
| Last Update Date | 10/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366262487 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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