Licking Memorial Professional Corporation

NPI #1457625758 in Newark, Ohio

Provider Information

NPI Number: 1457625758
Entity Type: Organization
Organization Name: Licking Memorial Professional Corporation
Primary Specialty: Dermatology
Enumeration Date: Mar 5, 2012
Last Updated: Mar 5, 2012

Practice Location

Address: 1272 WEST MAIN STREET BLDG 2 STE. 2
City: Newark
State: Ohio
ZIP Code: 43055
Phone: (740) 348-1760

Authorized Official

Name: CYNTHIA L. WEBSTER
Title: VP OF FINANCIAL SERVICES
Phone: (740) 348-4027

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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Provider Name	Specialty	City
Thomas J Hagele	Dermatology	Newark	AI Deep Dive
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DR. Kathleen M. Rogers, M.D.	Dermatology	Newark	AI Deep Dive

Organizations

Provider Name	Specialty	City
Licking Memorial Professional Corporation	Dermatology	Newark	AI Deep Dive
Licking Memorial Professional Corporation	Dermatology	Newark	AI Deep Dive

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