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Organization
LICKING MEMORIAL PROFESSIONAL CORPORATION
Active
Organization
LICKING MEMORIAL PROFESSIONAL CORPORATION
Active
Other names
Licking Memorial Oncology/Hematology
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT A. MONTAGNESE (EXECUTIVE VICE PRESIDENT)
(740) 348-4000
Entity
Organization
Contact information
Practice address
1320 W MAIN ST, NEWARK, OH 43055-1822
(740) 348-4475
(740) 348-4412
Mailing address
1320 W MAIN ST, NEWARK, OH 43055-1822
(740) 348-4475
(740) 348-4412
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
NULL
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Enumeration date
07/20/2006
Last updated
08/22/2020
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