Licking Memorial Professional Corporation
Urology in Newark, OH. Organization (NPI-2).
NPI number1508086554
StatusActive
Last updated in NPPESAug 3, 2011
Details
- NPI
- 1508086554
- Entity type
- Organization (NPI-2)
- Legal business name
- Licking Memorial Professional Corporation
- Organization subpart
- No
- Enumeration date
- May 1, 2007
- Last updated
- Aug 3, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208800000X | Urology | – | – | Yes |
Other names
- Licking Memorial Urology (Doing Business As)
Practice location
1272 West Main StreetBldg 4
Newark, OH 43055-2004
Phone 740-348-1750 · Fax 740-348-1751
Mailing address
1272 West Main StreetBldg 4
Newark, OH 43055-2004
Phone 740-348-1750 · Fax 740-348-1751
Authorized official
Cynthia L. Webster
Vp Of Financial Services
7403484518
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