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

Licking Memorial Professional Corp

Organization Surgery Physician · NPI 1366461386

Licking Memorial Professional Corp is a Surgery 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

1272 W Main St Bldg 3
Newark, OH 43055-2004
Phone: (740) 348-1880
Fax: (740) 348-1881
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X

Record details

NPI number1366461386
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robert Montagnese — Executive V.P. · (740) 348-4000
Other names Licking Memorial Surgical Services
NPI enumeratedJuly 19, 2006
Last updated in NPPESAugust 22, 2020
Mailing address1272 W Main St, Bldg. 3, Newark, OH 43055-2004

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