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

Licking Memorial Professional Corporation

Organization Dermatology Physician · NPI 1457625758

Licking Memorial Professional Corporation is a Dermatology Physician in Newark, Ohio. Registered with an NPI since 2012.

In the registry since
2012

Practice location Address checks out

1272 W Main St Bldg 2 Ste 2
Newark, OH 43055
Phone: (740) 348-1760
Fax: (740) 348-1761
Show map & directions

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

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1457625758
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cynthia Webster — Vp Of Financial Services · (740) 348-4027
Other names Licking Memorial Dermatology
NPI enumeratedMarch 5, 2012
Last updated in NPPESMarch 5, 2012
Mailing address1272 West Main Street Bldg 2 Ste. 2, Newark, OH 43055

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