Organization · Type 2 NPI

Licking Memorial Professional Corporation

Gynecology Physician · Newark, OH

NPI number 1053758631 Active

Practice location

270 Goosepond Road, Ste 102
Newark, OH 43055

Call (740) 348-7945 Map

Fax (740) 348-7946

Mailing address

270 Goosepond Rd., Ste 102
Newark, OH 43055

Specialties and licenses

Taxonomy	Code	License
Gynecology Physician Primary	207VG0400X	None listed

Gynecology Physician: A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions.

NPI record

NPI: 1053758631
Entity type: Organization (Type 2)
Issued: May 23, 2013
Last updated: May 23, 2013
Status: Active
Subpart: Yes of Licking Memorial Professional Corporation

Other names

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Licking Memorial Women's Health- North Newark · doing business as

Authorized official

Cynthia L. Webster
VP Financial Service
(740) 348-4518

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About NPI 1053758631

Licking Memorial Professional Corporation's National Provider Identifier is 1053758631, issued on May 23, 2013. The primary taxonomy on file is Gynecology Physician (207VG0400X), and the practice location is in Newark, OH. The record was last updated on May 23, 2013.