Licking Memorial Professional Corp.

NPI #1174541924 in Newark, Ohio

Provider Information

NPI Number: 1174541924
Entity Type: Organization
Organization Name: Licking Memorial Professional Corp.
Primary Specialty: Obstetrics & Gynecology
Enumeration Date: Jul 18, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 15 MESSIMER DR
City: Newark
State: Ohio
ZIP Code: 43055-1841
Phone: (740) 348-4694

Authorized Official

Name: ROBERT A. MONTAGNESE
Title: EXECUTIVE VP
Phone: (740) 348-4000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Obstetrics & Gynecology	207V00000X	Primary

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