LICKING MEMORIAL FAMILY PRACTICE
NPI 1336169770
Family Medicine in Newark, OH

Active since July 20, 2006
1272 W MAIN ST, BLDG. 1, NEWARK, OH 43055(740) 348-1702(740) 348-1703 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Licking Memorial Family Practice NPPES

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

LICKING MEMORIAL FAMILY PRACTICE (NPI 1336169770) is a healthcare organization registered as a family medicine in Newark, Ohio and active in the NPI registry since July 2006. The organization lists Robert A. Montagnese, Executive Vice President, as its authorized official.

NPPES Registry Identity

NPI1336169770
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLICKING MEMORIAL PROFESSIONAL CORPORATION
Location Address1272 W MAIN ST, BLDG. 1Newark, OH 43055-2004
Mailing Address1272 W Main St, Bldg. 1Newark, OH 43055-2004 · (740) 348-1702 · Fax (740) 348-1703
Fax(740) 348-1703
Organization SubpartNo
Authorized OfficialRobert A. MontagneseExecutive Vice President · (740) 348-4000
Enumeration DateJuly 20, 2006
Last NPPES UpdateAugust 22, 2020
NPI 1336169770 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1272 W MAIN ST, Newark, OH 43055

Other Names 1

Doing Business AsLicking Memorial Family Practice

Other Identifiers 1

Medicaid2140169OH

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 10

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

Family Medicine
1272 W MAIN ST, BLDG. 5
NEWARK, OH 43055
Podiatrist (Foot & Ankle Surgery)
1272 W MAIN ST, BUILDING #4
NEWARK, OH 43055
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1272 W MAIN ST, BLDG 2 STE 3
NEWARK, OH 43055
Pharmacy (Community/Retail Pharmacy)
1272 W MAIN ST
NEWARK, OH 43055
Surgery
1272 W MAIN ST, BLDG. 3
NEWARK, OH 43055
Surgery
1272 W MAIN ST, BLDG. 3
NEWARK, OH 43055
Family Medicine
1272 W MAIN ST, SUITE 503
NEWARK, OH 43055
Surgery (Plastic and Reconstructive Surgery)
1272 W MAIN ST, BLDG. 2
NEWARK, OH 43055

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 1336169770. It was assigned to this organization in the NPPES registry on July 20, 2006. The provider is doing business as Licking Memorial Family Practice.

Where is Licking Memorial Professional Corporation located?

Licking Memorial Professional Corporation is located at 1272 W Main St Bldg. 1, Newark, OH 43055. The listed phone number is (740) 348-1702.

What is Licking Memorial Professional Corporation's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

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 with the weekly NPPES data releases published by CMS.