Organization
LICKING MEMORIAL PROFESSIONAL CORPORATION
Active
Other names
Licking Memorial Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT A. MONTAGNESE (EXECUTIVE VICE PRESIDENT)
(740) 348-4000
Entity
Organization
Contact information
Practice address
150 MCMILLEN DR, NEWARK, OH 43055-1811
(740) 348-4827
(740) 348-1894
Mailing address
150 MCMILLEN DR, NEWARK, OH 43055-1811
(740) 348-4827
(740) 348-1894
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0119044
—
OH
Enumeration date
06/12/2006
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us