Licking Memorial Professional Corp

NPI #1730109166 in Newark, Ohio

Provider Information

NPI Number
1730109166
Entity Type
Organization
Organization Name
Licking Memorial Professional Corp
Primary Specialty
Internal Medicine
Enumeration Date
Jul 20, 2006
Last Updated
Aug 22, 2020

Practice Location

Address
120 MCMILLEN DR
City
Newark
State
Ohio
ZIP Code
43055-1809
Phone
(740) 348-4800

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Internal Medicine

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