# IMPACT MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487529764
- **Authorized official:** DR. BENJAMIN FOGG MD (PHYSICIAN)
- **Authorized official phone:** (801) 712-2535

## Contact information

- **Practice address:** 1776 N HIGHWAY 40, STE 101, HEBER CITY, UT 84032
- **Practice address phone:** (435) 294-2664
- **Practice address fax:** (801) 274-0049
- **Mailing address:** 1776 N HIGHWAY 40, STE 101, HEBER CITY, UT 84032
- **Mailing address phone:** (435) 294-2664
- **Mailing address fax:** (801) 274-0049

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | NULL | Yes |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/07/2025
- **Last updated:** 10/07/2025