OrganizationActive
Licking Memorial Professional Corp.
NPI 1154496503 · General Practice Physician · Newark, OH
Provider details
- NPI number
- 1154496503
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Cynthia Webster, Vp Financial Service(740) 348-4518
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2000 Tamarack Rd
Newark, OH 43055
Phone: (740) 348-1993
Fax: (740) 348-1994
Street-level locationGet directions
Mailing address
2000 Tamarack Rd
Newark, OH 43055
Other names (DBA / former)
- Doing business as
- Licking Memorial Physician Wound Services
Registry dates
- Enumerated
- 2006-11-21
- Last updated
- 2013-02-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.