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Organization

IMPACT PHYSICIAN GROUP, INDIANA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PAUL MILLER (CEO)
(678) 967-5599
Entity
Organization

Contact information

Practice address
1260 CITY CENTER DR, CARMEL, IN 46032-3810
(463) 333-9110
Mailing address
21 EASTBROOK BND STE 218, PEACHTREE CITY, GA 30269-1546
(678) 967-5599

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
207RG0100X
Gastroenterology Physician
207RP1001X
Pulmonary Disease Physician

Other

Enumeration date
11/10/2018
Last updated
07/28/2025
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