Licking Memorial Professional Corporation

NPI #1083646442 in Newark, Ohio

Provider Information

NPI Number
1083646442
Entity Type
Organization
Organization Name
Licking Memorial Professional Corporation
Primary Specialty
Otolaryngology
Enumeration Date
Jul 7, 2006
Last Updated
Aug 22, 2020

Practice Location

Address
88 MCMILLEN DR
City
Newark
State
Ohio
ZIP Code
43055-5814
Phone
(740) 348-4270

Authorized Official

Name
MR. ROBERT A. MONTAGENSE
Title
EXECUTIVE VICE PRESIDENT
Phone
(740) 348-4000

Specialties & Taxonomy Codes

Specialty
Otolaryngology

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