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LICKING MEMORIAL PROFESSIONAL CORP. NPI 1689690661


NPI Information

NPI: 1689690661
Provider Name: LICKING MEMORIAL PROFESSIONAL CORP.

Doing Business As: LICKING MEMORIAL FAMILY PRACTICE HEBRON

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 36D2124438

Address:
96 INTEGRITY DRIVE
H.
HEBRON, OH
ZIP 43025
Phone: (740) 348-7930
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LICKING MEMORIAL PROFESSIONAL CORP. is a family medicine in Hebron, OH. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. LICKING MEMORIAL PROFESSIONAL CORP. NPI is 1689690661. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Licking Memorial Family Practice Hebron.

The provider's business location address is:

96 INTEGRITY DRIVE
H.
HEBRON, OH
ZIP 43025
Phone: (740) 348-7930
Fax: (740) 348-7931

The provider's authorized official is Robert A. Montagnese .
The authorized official title is Executive V.p. and has the following contact phone number (740) 348-4000.

The CLIA number assigned to this NPI record is 36D2124438 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/14/2006 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.