IMPACT PHYSICIAN GROUP, LOUISIANA LLC

LAKE CHARLES, LA
NPI1437775459
Entity TypeOrganization
Authorized ContactPAUL MILLER
Credentialing Coordinator
260-407-8009
Organization Subpart ?No
Primary Taxonomy207R00000X Internal Medicine
Enumeration Date2020-06-25
Last Update Date2020-06-25
Business Address
IMPACT PHYSICIAN GROUP, LOUISIANA LLC
2720 RUE DE JARDIN STE 100
LAKE CHARLES, LA 70605-4050
Phone number: 260-407-8009
Mailing Address
IMPACT PHYSICIAN GROUP, LOUISIANA LLC
21 EASTBROOK BND STE 218
PEACHTREE CITY, GA 30269-1546
Phone number: 260-407-8009
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