Organization
IMPACT PHYSICIAN GROUP, IOWA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL MILLER (CEO)
(678) 967-5599
Entity
Organization
Contact information
Practice address
2801 HEARTLAND DR, CORALVILLE, IA 52241-2733
(319) 645-4001
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
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
10/01/2020
Last updated
12/19/2022
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