Licking Memorial Professional Corporation

NPI #1376585430 in Newark, Ohio

Provider Information

NPI Number: 1376585430
Entity Type: Organization
Organization Name: Licking Memorial Professional Corporation
Primary Specialty: Anesthesiology
Enumeration Date: Jun 12, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 1320 W MAIN ST
City: Newark
State: Ohio
ZIP Code: 43055-1822
Phone: (740) 348-4226

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Anesthesiology	207L00000X	Primary

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