LICKING MEMORIAL PHYSICIAN WOUND SERVICES – NPI #1154496503
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

LICKING MEMORIAL PHYSICIAN WOUND SERVICES is a provider located in NEWARK, OH. NPPES has assigned the NPI number 1154496503 to LICKING MEMORIAL PHYSICIAN WOUND SERVICES on November 21, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “LICKING MEMORIAL PHYSICIAN WOUND SERVICES” is a dba name, the actual legal business name for this organization is LICKING MEMORIAL PROFESSIONAL CORP.. The primary taxonomy selected by this provider is 208D00000X from the Health Care Provider Taxonomy code set, which is classified as General Practice.

The NPI profile was previously updated about 13 years ago on Feb 18, 2013. 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 PHYSICIAN WOUND SERVICES below.

NPI Profile for
LICKING MEMORIAL PROFESSIONAL CORP.

NPI Number
1154496503
Enumeration Date

(more than 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 CORP.
Doing Business As (dba): LICKING MEMORIAL PHYSICIAN WOUND SERVICES
Primary location
2000 TAMARACK RD
NEWARK, OH 43055
Phone: (740) 348-1993 Fax: (740) 348-1994
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
CYNTHIA WEBSTER
VP FINANCIAL SERVICE
Phone: (740) 348-4518
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
208D00000X
- General Practice (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.