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

Licking Memorial Professional Corporation

Organization Family Medicine Physician · NPI 1093757155

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

In the registry since
2006

Practice location Address checks out

150 McMillen Dr
Newark, OH 43055-1811
Phone: (740) 348-4827
Fax: (740) 348-1894
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 number1093757155
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robert Montagnese — Executive Vice President · (740) 348-4000
Other names Licking Memorial Family Practice
NPI enumeratedJune 12, 2006
Last updated in NPPESAugust 22, 2020
Mailing address150 McMillen Dr, Newark, OH 43055-1811

Other providers in Newark