National Provider Identifier Database

LICKING MEMORIAL PROFESSIONAL CORP
Geriatric Medicine

A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.


Contact Information

LICKING MEMORIAL PROFESSIONAL CORP
1450 W MAIN ST
NEWARK, OH43055-1825
Phone: 740-348-7935
Fax: 740-348-7936
Website:
Specialty Taxonomy Code
* Geriatric Medicine 207QG0300X

* Indicates primary specialty

NPI Profile & details for LICKING MEMORIAL PROFESSIONAL CORP

NPI Number 1497937510
Legal business name
LBN
LICKING MEMORIAL PROFESSIONAL CORP
Authorized official THOMAS POULSON - (CFO)
Entity Organization
Organization subpart No
Enumeration date 11/30/2007
Last updated 11/30/2007 - About 19 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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