Individual
TIMOTHY J. HENRIKSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14300 E 138TH STE B, FISHERS, IN 46037-0051
(800) 622-6575
Mailing address
3600 W BETHEL AVE, MUNCIE, IN 47304-5407
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01050725A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200342630
—
IN
Enumeration date
03/02/2006
Last updated
08/04/2025
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