LICKING MEMORIAL PROFESSIONAL CORP NPI 1073822938

NPI Information

  • NPI: 1073822938
  • Provider Name: LICKING MEMORIAL PROFESSIONAL CORP
  • Classification: Internal Medicine - 207RE0101X
  • Specialization: Endocrinology, Diabetes & Metabolism
  • Entity Type: Organization
  • Doing Business As: LICKING MEMORIAL ENDOCRINOLOGY
  • Address: 1272 W MAIN ST
    BLDG 2 STE 3
    NEWARK, OH
    ZIP 43055
  • Phone: (740) 348-7950

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NPI Details

LICKING MEMORIAL PROFESSIONAL CORP is an endocrinology and diabetes and metabolism internal medicine in Newark, OH. The provider is an internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. LICKING MEMORIAL PROFESSIONAL CORP NPI is 1073822938. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Licking Memorial Endocrinology.

The provider's business location address is:

1272 W MAIN ST
BLDG 2 STE 3
NEWARK, OH
ZIP 43055-004
Phone: (740) 348-7950
Fax: (740) 348-7951

The provider's authorized official is Cynthia L Webster .
The authorized official title is Vp Of Financial Services and has the following contact phone number (740) 348-4518.

The enumeration date for this NPI number is 9/27/2010 and was last updated on 7/31/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RE0101XInternal MedicineEndocrinology, Diabetes & MetabolismYes

What is NPI?

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This page was last updated on: 11/21/2025

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