OrganizationActive
Licking Memorial Professional Corp.
NPI 1598945818 · Geriatric Medicine (Family Medicine) Physician · Newark, OH
Provider details
- NPI number
- 1598945818
- Entity type
- Organization
- Primary specialty
- Geriatric Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Thomas Poulson, Cfo(740) 348-4110
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
717 S 30th St
Newark, OH 43056-1244
Phone: (740) 348-7935
Fax: (740) 348-7936
Approximate (ZIP-level) locationGet directions
Mailing address
717 S 30th St
Newark, OH 43056-1244
Other names (DBA / former)
- Doing business as
- Licking Memorial Geriatric Medicine at Hnc
Registry dates
- Enumerated
- 2007-11-05
- Last updated
- 2007-11-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.