Organization
IMPACT MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN FOGG MD (PHYSICIAN)
(801) 712-2535
Entity
Organization
Contact information
Practice address
1776 N HIGHWAY 40, STE 101, HEBER CITY, UT 84032
(435) 294-2664
(801) 274-0049
Mailing address
1776 N HIGHWAY 40, STE 101, HEBER CITY, UT 84032
(435) 294-2664
(801) 274-0049
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
—
—
Other
Enumeration date
10/07/2025
Last updated
10/07/2025
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