Individual
TIMOTHY P BURNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1801 N SENATE BLVD., SUITE 535, INDIANAPOLIS, IN 46202-1204
(317) 963-1950
(317) 963-1955
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001388A
IN
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000851588
ANTHEM PIN
IN
01
—
264430178
MEDICARE PTAN
IN
05
—
300009783
—
IN
Enumeration date
01/25/2012
Last updated
01/31/2024
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