LICKING MEMORIAL PROFESSIONAL CORP. NPI 1154496503

NPI Information

LICKING MEMORIAL PROFESSIONAL CORP. is a general practice in Newark, OH. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee LICKING MEMORIAL PROFESSIONAL CORP. NPI is 1154496503. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Licking Memorial Physician Wound Services.

The provider's business location address is:

2000 TAMARACK RD
NEWARK, OH
ZIP 43055
Phone: (740) 348-1993
Fax: (740) 348-1994

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

The enumeration date for this NPI number is 11/21/2006 and was last updated on 2/18/2013.

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:

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