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

Impact Physician Group, Pediatrics LLC

Organization Pediatrics Physician · NPI 1689290603

Impact Physician Group, Pediatrics LLC is a Pediatrics Physician in Lake Charles, Louisiana. Registered with an NPI since 2020.

In the registry since
2020
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

2720 Rue De Jardin Ste 100
Lake Charles, LA 70605-4050
Phone: (260) 407-8009
Fax: (260) 407-8009
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X

Record details

NPI number1689290603
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Paul Miller — Ceo · (678) 967-5599
NPI enumeratedJune 25, 2020
Last updated in NPPESMarch 15, 2022
Certification dateMarch 15, 2022
Mailing address21 Eastbrook Bnd Ste 218, Peachtree City, GA 30269-1546

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