1. Home
  2. Directory
  3. Ohio
  4. Newark
  5. Dermatology
  6. NPI Profile

LICKING MEMORIAL DERMATOLOGY
NPI 1295775435
Dermatology in Newark, OH

Active since June 07, 2006
36 MCMILLEN DR, NEWARK, OH 43055(740) 348-1755(740) 348-1756 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Licking Memorial Dermatology NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LICKING MEMORIAL DERMATOLOGY (NPI 1295775435) is a healthcare organization registered as a dermatology in Newark, Ohio and active in the NPI registry since June 2006. The organization lists Robert A. Montagnese, Executive Ice President, as its authorized official.

NPPES Registry Identity

NPI1295775435
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameLICKING MEMORIAL PROFESSIONAL CORPORATION
Location Address36 MCMILLEN DRNewark, OH 43055-3666
Mailing Address36 Mcmillen DrNewark, OH 43055-3666 · (740) 348-1755 · Fax (740) 348-1756
Phone(740) 348-1755
Fax(740) 348-1756
Organization SubpartNo
Authorized OfficialRobert A. MontagneseExecutive Ice President · (740) 348-4000
Enumeration DateJune 7, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1295775435 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
36 MCMILLEN DR, Newark, OH 43055
Open in Google Maps ↗

Other Names 1

Doing Business AsLicking Memorial Dermatology

Other Identifiers 1

Medicaid2527975OH

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BRADLEY R LAWSON M.D.
Otolaryngology
36 MCMILLEN DR
NEWARK, OH 43055
Licking County (220) 564-4270
LYNNE DUVALL
Audiologist
36 MCMILLEN DR
NEWARK, OH 43055
Licking County (740) 344-1304
CHERYL B BARKER
Audiologist
36 MCMILLEN DR
NEWARK, OH 43055
Licking County (740) 344-1304
DR. KENNETH CARROLL PARKER M.D.
Otolaryngology (Facial Plastic Surgery)
36 MCMILLEN DR
NEWARK, OH 43055
Licking County (220) 564-4270

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Licking Memorial Professional Corporation's NPI number?

The NPI number for Licking Memorial Professional Corporation is 1295775435. It was assigned to this organization in the NPPES registry on June 7, 2006. The provider is doing business as Licking Memorial Dermatology.

Where is Licking Memorial Professional Corporation located?

Licking Memorial Professional Corporation is located at 36 Mcmillen Dr, Newark, OH 43055. The listed phone number is (740) 348-1755.

What is Licking Memorial Professional Corporation's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

When was this NPI record last updated?

The NPPES record for Licking Memorial Professional Corporation was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.