Organization · Type 2 NPI

Licking Memorial Professional Corporation

Surgery Physician · Pataskala, OH

NPI number 1093955932 Active

Practice location

1 Healthy Pl Ste 202
Pataskala, OH 43062-7067

Call (740) 348-1935 Map

Fax (740) 348-1936

Specialties and licenses

Taxonomy	Code	License
Surgery Physician Primary	208600000X	34008308 (OH)

Surgery Physician: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasin…

NPI record

NPI: 1093955932
Entity type: Organization (Type 2)
Issued: Mar 5, 2009
Last updated: Mar 6, 2009
Status: Active
Subpart: Yes of Licking Memorial Professional Corporation

Other names

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Licking Memorial Pataskala Specialties · doing business as

Authorized official

Cynthia Webster
VP Revenue Cycle & Interim VP Finan
(740) 348-4027

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1093955932

Licking Memorial Professional Corporation's National Provider Identifier is 1093955932, issued on Mar 5, 2009. The primary taxonomy on file is Surgery Physician (208600000X), and the practice location is in Pataskala, OH. The record was last updated on Mar 6, 2009.