Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Impact Physician Group, LLC

Organization Internal Medicine Physician · NPI 1366262487

Impact Physician Group, LLC is an Internal Medicine Physician in South Ogden, Utah. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5825 Harrison Blvd
South Ogden, UT 84403-4316
Phone: (801) 475-5254
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X

Record details

NPI number1366262487
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Paul Miller — Ceo · (678) 967-5599
NPI enumeratedOctober 14, 2024
Last updated in NPPESOctober 14, 2024
Certification dateOctober 14, 2024
Mailing addressPo Box 744577, Atlanta, GA 30374-4577

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