Gillum, Timothy G
Gillum, Timothy G is an sole proprietor health care provider with primary practice located at 801 W Gardner Dr , Marion IN 46952-1819. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Gillum, Timothy G can be contacted via phone (765) 651-4278.Contact Information
Primary practice address
801 W Gardner Dr
Marion IN 46952-1819
Phone: (765) 651-4278
Fax: (765) 664-6445
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 01055912A | Indiana |
Profile Details
| NPI number | 1316994791 |
|---|---|
| LBN Legal business name | Gillum, Timothy G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 30th, 2006 |
| Last updated | May 9th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316994791 | NPPES |
| Indiana | MEDICAID | 200434290A |
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