Organization
LICKING MEMORIAL PROFESSIONAL CORPORATION
Active
Other names
Licking Memorial Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA L. WEBSTER (VP OF FINANCIAL SERVICES)
(740) 348-4027
Entity
Organization
Contact information
Practice address
1272 WEST MAIN STREET BLDG 2 STE. 2, NEWARK, OH 43055
(740) 348-1760
(740) 348-1761
Mailing address
1272 WEST MAIN STREET BLDG 2 STE. 2, NEWARK, OH 43055
(740) 348-1760
(740) 348-1761
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
03/05/2012
Last updated
03/05/2012
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