Licking Memorial Professional Corp
Pediatrics
Licking Memorial Professional Corp is a Newark, Ohio based Pediatric center with medical specialization in
General Pediatrics. Licking Memorial Professional Corp is doing business as
Licking Memorial Pediatrics.
It is located at
1865 Tamarack Rd, Newark, Ohio - 43055-2305. They can be contacted on phone at
740-348-4940 and fax number 740-348-4948.
NPI number (Unique professional ID) for Licking Memorial Professional Corp is
1083634414 which was assigned by NPPES on 20 Jul, 2006 and it was last updated on 22 Aug, 2020.
Licking Memorial Professional Corp is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Licking Memorial Professional Corp basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Licking Memorial Professional Corp |
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| Other Name : | Licking Memorial Pediatrics |
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Business Address:
Licking Memorial Professional Corp address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 1865 Tamarack Rd
Newark, OH, 43055-2305
United States |
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| Phone Number : | 740-348-4940 |
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| Fax Number : | 740-348-4948 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1083634414 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 20 Jul, 2006 |
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| Last Updated On : | 22 Aug, 2020 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Roberta. Montagnese |
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| Official Title or Position : | EXECUTIVE V.P. |
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| Phone Number : | 740-348-4000 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Licking Memorial Professional Corp are as mentioned. Primary taxonomy code for Licking Memorial Professional Corp is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | | |
Legacy Identifiers:
Other legacy medical identifiers of Licking Memorial Professional Corp such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 0617194 | MEDICAID | OH | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 1865 Tamarack Rd
Newark, OH, 43055-2305
United States |
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| Phone Number : | 740-348-4940 |
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| Fax Number : | 740-348-4948 |
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Business Location:
Patients can refer following map for directions to
Licking Memorial Professional Corp practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.