LICKING MEMORIAL RECONSTRUCTIVE & COSMETIC SERVICES – NPI #1831381706
Surgery

A surgeon who specializes in plastic and reconstructive surgery.

LICKING MEMORIAL RECONSTRUCTIVE & COSMETIC SERVICES is a surgeon located in NEWARK, OH. NPPES has assigned the NPI number 1831381706 to LICKING MEMORIAL RECONSTRUCTIVE & COSMETIC SERVICES on August 15, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “LICKING MEMORIAL RECONSTRUCTIVE & COSMETIC SERVICES” is a dba name, the actual legal business name for this organization is LICKING MEMORIAL PROFESSIONAL CORPORATION. The primary taxonomy selected by this provider is 2086S0122X from the Health Care Provider Taxonomy code set, which is classified as Surgery, specializing in Plastic and Reconstructive Surgery

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LICKING MEMORIAL RECONSTRUCTIVE & COSMETIC SERVICES below.

NPI Profile for
LICKING MEMORIAL PROFESSIONAL CORPORATION

NPI Number
1831381706
Enumeration Date

(about 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LICKING MEMORIAL PROFESSIONAL CORPORATION
Doing Business As (dba): LICKING MEMORIAL RECONSTRUCTIVE & COSMETIC SERVICES
Primary location
1272 W MAIN ST
BLDG. 2
NEWARK, OH 43055-2004
Phone: (740) 348-7955 Fax: (740) 348-7956
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
RENEE SPRING-IVES
CREDENTIALING COORDINATOR
Phone: (740) 348-4027
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2086S0122X
- Surgery / Plastic and Reconstructive Surgery (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.