Individual
TIMOTHY G GILLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 W GARDNER DR, MARION, IN 46952-1819
(765) 651-4278
(765) 664-6445
Mailing address
801 W GARDNER DR, MARION, IN 46952-1819
(765) 651-4278
(765) 664-6445
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01055912A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200434290A
—
IN
Enumeration date
05/30/2006
Last updated
05/09/2016
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