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 1700291416

Licking Memorial Professional Corporation is a Dermatology Physician in Pataskala, Ohio. Registered with an NPI since 2014.

In the registry since
2014

Practice location Address checks out

1 Healthy Pl Ste 205
Pataskala, OH 43062-7067
Phone: (740) 348-1930
Fax: (740) 348-1931
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 number1700291416
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationLicking Memorial Professional Corporation
Authorized official Cynthia Webster — Vp Financial Services · (740) 348-4518
Other names Licking Memorial Dermatology Pataskala
NPI enumeratedJune 23, 2014
Last updated in NPPESJune 23, 2014
Mailing address1 Healthy Pl, Suite 205, Pataskala, OH 43062-7067

Other providers in Pataskala