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

Licking Memorial Professional Corp

Organization Internal Medicine Physician · NPI 1730109166

Licking Memorial Professional Corp is an Internal 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

120 McMillen Dr
Newark, OH 43055-1809
Phone: (740) 348-4800
Fax: (740) 348-4801
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X

Record details

NPI number1730109166
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robert Montagnese — Executive V.P · (740) 348-4000
Other names Licking Memorial Internal Medicine
NPI enumeratedJuly 20, 2006
Last updated in NPPESAugust 22, 2020
Mailing address120 McMillen Dr, Newark, OH 43055-1809

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