| Licking Memorial Professional Corporation | |
|
1320 W Main St Newark OH 43055-1822 | |
| (740) 348-4137 | |
| (740) 348-4119 |
| Full Name | Licking Memorial Professional Corporation |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 1320 W Main St, Newark, Ohio |
| Authorized Official Name and Position | Robert A. Montagnese (EXECUTIVE V.P.) |
| Authorized Official Contact | 7403484000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Licking Memorial Professional Corporation 1320 W Main St Newark OH 43055-1822 Ph: (740) 348-4137 | Licking Memorial Professional Corporation 1320 W Main St Newark OH 43055-1822 Ph: (740) 348-4137 |
| NPI Number | 1770503112 |
|---|---|
| Provider Enumeration Date | 07/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770503112 | NPI | - | NPPES |
| 2574610 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
Licking Memorial Professional Corp. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2181 W High St, Newark, OH 43055 Phone: 740-348-1720 Fax: 740-348-1726 | |
Licking Memorial Professional Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 399 E Main St, Newark, OH 43055 Phone: 740-348-1849 Fax: 740-348-1847 | |
Licking Memorial Professional Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1272 W Main St, Bldg 2 Ste 3, Newark, OH 43055 Phone: 740-348-7950 Fax: 740-348-7951 | |
Licking Memorial Professional Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 Mcmillen Dr, Newark, OH 43055 Phone: 740-348-4827 Fax: 740-348-1894 | |
Primetown Ohio Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 905 N 21st St Ste A, Newark, OH 43055 Phone: 740-281-3663 Fax: 740-281-3818 | |
Lower Lights Christian Health Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 69 S Terrace Ave, Newark, OH 43055 Phone: 614-274-1455 Fax: 614-274-1433 | |
Licking Memorial Professional Corp. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2000 Tamarack Rd, Newark, OH 43055 Phone: 740-348-1993 Fax: 740-348-1994 |