Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Licking Memorial Professional Corp

Organization Family Medicine Physician · NPI 1013935865

Licking Memorial Professional Corp is a Family Medicine Physician in Newark, Ohio. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2181 W High St
Newark, OH 43055-8917
Phone: (740) 348-1720
Fax: (740) 348-1726
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1013935865
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robert Montagnese — Executive V.P. · (740) 348-4000
Other names Licking Memorial Family Practice Licking Valley
NPI enumeratedJuly 18, 2006
Last updated in NPPESAugust 22, 2020
Mailing address2181 W High St, Newark, OH 43055-8917

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