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Organization
LICKING MEMORIAL PROFESSIONAL CORPORATION
Active
Organization
LICKING MEMORIAL PROFESSIONAL CORPORATION
Active
Other names
Licking Memorial Pathologists
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA L. WEBSTER (VP FINANCIAL SERVICE)
(740) 348-4518
Entity
Organization
Contact information
Practice address
1320 W MAIN ST, NEWARK, OH 43055-1822
(740) 348-4266
Mailing address
PO BOX 4056, NEWARK, OH 43058-4056
(740) 348-4266
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2178889
—
OH
Enumeration date
12/29/2005
Last updated
07/26/2013
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