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 1740472604

Licking Memorial Professional Corporation is a Dermatology Physician in Newark, Ohio. Registered with an NPI since 2007.

In the registry since
2007

Practice location Address checks out

270 Goosepond Rd
Newark, OH 43055-3104
Phone: (740) 348-7945
Fax: (740) 348-7946
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 number1740472604
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Renee Spring-Ives — Credentialing Coordnator · (740) 348-4027
Other names Licking Memorial Dermatology North Newark
NPI enumeratedAugust 15, 2007
Last updated in NPPESAugust 15, 2007
Mailing address270 Goosepond Rd, Newark, OH 43055-3104

Other providers in Newark