LICKING MEMORIAL PROFESSIONAL CORP. NPI 1891715223

NPI Information

LICKING MEMORIAL PROFESSIONAL CORP. is a preventive medicine/occupational environmental medicine preventive medicine in Newark, OH. The provider is a preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. LICKING MEMORIAL PROFESSIONAL CORP. NPI is 1891715223. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Licking Memorial Occupational Medicine.

The provider's business location address is:

1865 TAMARACK RD
NEWARK, OH
ZIP 43055-305
Phone: (740) 348-4972
Fax: (740) 348-4991

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

The enumeration date for this NPI number is 7/20/2006 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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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.