Medical school: MEDICAL COLLEGE OF OHIO
Graduated: 1986
NPI: 1326046541
Practice Locations (4)
LICKING MEMORIAL PROFESSIONAL CORPORATION
1264 WEAVER DR
GRANVILLE, OH 430231257
2205641940
LICKING MEMORIAL PROFESSIONAL CORPORATION
120 MCMILLEN DR
NEWARK, OH 430551809
2205644806
LICKING MEMORIAL PROFESSIONAL CORPORATION
36 MCMILLEN DR
NEWARK, OH 430551809
2205644270
LICKING MEMORIAL PROFESSIONAL CORPORATION
88 MCMILLEN DR
NEWARK, OH 430551809
2205644270
Source: CMS National Downloadable File, September 2026.