Organization
IMPACT PHYSICIAN GROUP NEUROLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL MILLER CEO (CEO)
(678) 967-5599
Entity
Organization
Contact information
Practice address
10018 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 208-6000
Mailing address
21 EASTBROOK BND STE 218, PEACHTREE CITY, GA 30269-1546
(678) 967-5599
(678) 519-2831
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
06/27/2025
Last updated
07/28/2025
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