Licking Memorial Professional Corporation

NPI #1861412207 in Newark, Ohio

Provider Information

NPI Number: 1861412207
Entity Type: Organization
Organization Name: Licking Memorial Professional Corporation
Primary Specialty: Internal Medicine
Enumeration Date: Jul 20, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 1320 W MAIN ST
City: Newark
State: Ohio
ZIP Code: 43055-1822
Phone: (740) 348-1791

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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