Organization
LICKING MEMORIAL PROFESSIONAL CORPORATION
Active
Other names
Licking Memorial Urology
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 WEST MAIN STREET, BLDG 4, NEWARK, OH 43055-2004
(740) 348-1750
(740) 348-1751
Mailing address
1272 WEST MAIN STREET, BLDG 4, NEWARK, OH 43055-2004
(740) 348-1750
(740) 348-1751
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
05/01/2007
Last updated
08/03/2011
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