Impact Physician Group, LLC

NPI #1366262487 in South Ogden, Utah

Provider Information

NPI Number: 1366262487
Entity Type: Organization
Organization Name: Impact Physician Group, LLC
Primary Specialty: Internal Medicine
Enumeration Date: Oct 14, 2024
Last Updated: Oct 14, 2024

Practice Location

Address: 5825 HARRISON BLVD
City: South Ogden
State: Utah
ZIP Code: 84403-4316
Phone: (801) 475-5254

Authorized Official

Name: PAUL MILLER
Title: CEO
Phone: (678) 967-5599

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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