IMPACT PHYSICIAN GROUP, MISSOURI, LLC

BRIDGETON, MO
NPI1962971531
Entity TypeOrganization
Authorized ContactPAUL MILLER
CEO
678-967-5599
Organization Subpart ?No
Primary Taxonomy207R00000X Internal Medicine
Additional Taxonomies207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism
207RG0100X Internal Medicine, Gastroenterology
207RP1001X Internal Medicine, Pulmonary Disease
Enumeration Date2018-11-13
Last Update Date2022-12-19
Business Address
IMPACT PHYSICIAN GROUP, MISSOURI, LLC
12380 DE PAUL DR
BRIDGETON, MO 63044-2511
Phone number: 314-447-9700
Mailing Address
IMPACT PHYSICIAN GROUP, MISSOURI, LLC
21 EASTBROOK BND STE 218
PEACHTREE CITY, GA 30269-1546
Phone number: 678-967-5599