Dermatology
LICKING MEMORIAL PROFESSIONAL CORPORATION
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1295775435 · enumerated 2006-06-07 · record updated 2020-08-22. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: ROBERT MONTAGNESE, Executive ice President · (740) 348-4000
Other names: LICKING MEMORIAL DERMATOLOGY
Addresses and phones
- Mailing address 36 MCMILLEN DR, NEWARK, OH, 43055-3666 (740) 348-1755 Fax (740) 348-1756 Google Maps Apple Maps OpenStreetMap
- Practice location 36 MCMILLEN DR, NEWARK, OH, 43055-3666 (740) 348-1755 Fax (740) 348-1756 Google Maps Apple Maps OpenStreetMap
Specialties
- Dermatology 207N00000X · Primary
In this directory
Locations and evidence
-
Practice location
NEWARK, OH, 430553666
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.