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General NPI Number Information
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NPI Number | 1124680509
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Entity Type | Organization
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Legal Business Name | LIMA MEMORIAL PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/05/2019
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 525 N EASTOWN RD
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City | LIMA
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State | OH
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Zip | 45807-2268
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Country | US
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Telephone | 419-998-8214
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Fax | 419-998-9298
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Provider Business Mailing Address
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Address Line | 1001 BELLEFONTAINE AVE
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City | LIMA
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State | OH
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Zip | 45804-2800
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Country | US
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Telephone | 419-998-4575
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Fax | 419-998-4586
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Authorized Official
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Title or Position | DIRECTOR OF LMP
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Name | JEFFREY UTZ
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Credential |
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Telephone | 419-998-4668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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