OrganizationActive
Licking Memorial Professional Corporation
NPI 1952581274 · Geriatric Medicine (Family Medicine) Physician · Newark, OH
Provider details
- NPI number
- 1952581274
- 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
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 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
151 Price Rd
Newark, OH 43055-3317
Phone: (740) 348-7935
Fax: (740) 348-7936
Street-level locationGet directions
Mailing address
151 Price Rd
Newark, OH 43055-3317
Other names (DBA / former)
- Doing business as
- Licking Memorial Geriatric Medicine at LPN
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.