Organization
IMPACT PHYSICIAN GROUP, PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL MILLER (CEO)
(678) 967-5599
Entity
Organization
Contact information
Practice address
302 GOBBLERS KNOB RD, LUFKIN, TX 75904-5419
(678) 967-5599
Mailing address
21 EASTBROOK BND STE 218, PEACHTREE CITY, GA 30269-1546
(678) 967-5599
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
12/21/2021
Last updated
03/15/2022
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