Organization
LICKING MEMORIAL PROFESSIONAL CORP
Active
Other names
Licking Memorial Endocrinology
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA L WEBSTER (VP OF FINANCIAL SERVICES)
(740) 348-4518
Entity
Organization
Contact information
Practice address
1272 W MAIN ST, BLDG 2 STE 3, NEWARK, OH 43055-2004
(740) 348-7950
(740) 348-7951
Mailing address
1272 W MAIN ST, BLDG 2 STE 3, NEWARK, OH 43055-2004
(740) 348-7950
(740) 348-7951
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Enumeration date
09/27/2010
Last updated
07/31/2012
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