Organization
IMPACT PHYSICIAN GROUP, INDIANA, PULMONARY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL MILLER CEO (CEO)
(678) 967-5599
Entity
Organization
Contact information
Practice address
1700 W 10TH ST, INDIANAPOLIS, IN 46222-3802
(317) 636-4400
Mailing address
21 EASTBROOK BND STE 218, PEACHTREE CITY, GA 30269-1546
(678) 967-5599
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Enumeration date
12/05/2018
Last updated
12/19/2022
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