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

Licking Memorial Professional Corp

Organization Preventive Medicine/Occupational Environmental Medicine Physician · NPI 1891715223

Licking Memorial Professional Corp is a Preventive Medicine/Occupational Environmental 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.

See every abbreviation used in this directory →

Practice location Address checks out

1865 Tamarack Rd
Newark, OH 43055-2305
Phone: (740) 348-4972
Fax: (740) 348-4991
Show map & directions

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

Specialties & licences

Preventive Medicine/Occupational Environmental Medicine Physician (primary) Taxonomy 2083P0500X

Record details

NPI number1891715223
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robert Montagense — Executive V.P. · (740) 348-4000
Other names Licking Memorial Occupational Medicine
NPI enumeratedJuly 20, 2006
Last updated in NPPESAugust 22, 2020
Mailing address1865 Tamarack Rd, Newark, OH 43055-2305