Licking Memorial Dermatology

LBN: Licking Memorial Professional Corporation
Licking Memorial Dermatology is an health care organization with primary practice located at 36 Mcmillen Dr , Newark OH 43055-3666. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Licking Memorial Professional Corporation can be contacted via phone (740) 348-1755, or through Montagnese, Robert A. via phone (740) 348-4000.

Contact Information

Primary practice address
36 Mcmillen Dr Newark OH 43055-3666
Phone: (740) 348-1755
Fax: (740) 348-1756
Website:
Map and Directions
Authorized official contact:
Name: Montagnese, Robert A.
Phone: (740) 348-4000

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X

Profile Details

NPI number 1295775435
LBN Legal business name Licking Memorial Professional Corporation
DBA Doing business as Licking Memorial Dermatology
Authorized official Montagnese, Robert A.
Entity Organization
Organization subpart 1 No
Enumeration date Jun 7th, 2006
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295775435 NPPES
Ohio MEDICAID 2527975

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