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

Licking Memorial Professional Corp

Organization Family Medicine Physician · NPI 1255365102

Licking Memorial Professional Corp is a Family Medicine Physician in Johnstown, 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

151 Woodgate Dr
Johnstown, OH 43031-1198
Phone: (740) 348-1810
Fax: (740) 348-1811
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1255365102
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robert Montagnese — Executive V.P · (740) 348-4000
Other names Licking Memorial Family Practice Johnstown
NPI enumeratedJuly 10, 2006
Last updated in NPPESAugust 22, 2020
Mailing address151 Woodgate Dr, Johnstown, OH 43031-1198

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