Licking Memorial Professional Corp.

NPI #1366461386 in Newark, Ohio

Provider Information

NPI Number: 1366461386
Entity Type: Organization
Organization Name: Licking Memorial Professional Corp.
Primary Specialty: Surgery
Enumeration Date: Jul 19, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 1272 W MAIN ST
Address 2: BLDG. 3
City: Newark
State: Ohio
ZIP Code: 43055-2004
Phone: (740) 348-1880

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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