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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