GILLUM FACIAL PLASTIC SURGERY, PC (NPI# 1063563617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063563617 |
| Entity Type | Organization |
| Organization Name | GILLUM FACIAL PLASTIC SURGERY, PC |
| Practice Address |
330 N Wabash Ave Ste 210 Marion IN 46952-2600 |
| Mailing Address |
Po Box 2063 Indianapolis IN 46206-2063 |
| Practice Telephone | 7656514278 |
| Practice Fax Number | 7656646445 |
| Mailing Telephone | 7656514278 |
| Mailing Fax Number | 7656646445 |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | TIMOTHY G GILLUM (OWNER) |
| Authorized Official Telephone | 7656514278 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 0155912A | IN | Other Service Providers |
| Street Address |
330 N WABASH AVE STE 210 |
| City | MARION |
| State | IN |
| Zip Code | 46952-2600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174525356 | Kristine A Hess | Dermatology | 330 N Wabash Ave, #360, Marion, IN 46952-2696 | 2005-06-01 |
| 1508194978 | Podiatry Practice Helpers | Spec/Tech, Health Info | 330 N Wabash Ave, Ste 460a, Marion, IN 46952-2696 | 2009-11-24 |
| 1447404074 | Pierre James Fisher Jr. | Specialist | 330 N Wabash Ave, Suite 450, Marion, IN 46952-2696 | 2008-11-10 |
| 1912185661 | Douglas Aaron Rex | Surgery | 330 N Wabash Ave, Ste G370, Marion, IN 46952-2678 | 2008-02-05 |
| 1235319740 | Sarah Olivia Lingo | Audiologist | 330 N Wabash Ave, Suite 210, Marion, IN 46952-2696 | 2007-11-13 |
| 1518146703 | Physicians' Billing of Mgh | Internal Medicine | 330 N Wabash Ave, Suite 430, Marion, IN 46952-2686 | 2007-10-24 |
| 1285822189 | Physicians' Billing of Mgh | Psychiatry & Neurology | 330 N Wabash Ave, Suite 340, Marion, IN 46952-2678 | 2007-10-05 |
| 1447468830 | Surgeons, Inc | Surgery | 330 N Wabash Ave, Suite 450, Marion, IN 46952-2600 | 2007-05-18 |
| 1306979034 | Surgical Associates PC | Surgery | 330 N Wabash Ave, Suite 440, Marion, IN 46952-2600 | 2007-03-13 |
| 1538204870 | Dermatology, PC | Dermatology | 330 N Wabash Ave, #360, Marion, IN 47342-9999 | 2007-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982245874 | John Robert Searfoss Sr. | Counselor | 314 S Norton Ave., Marion, IN 46952 | 2019-10-02 |
| 1063069755 | Andrea Marie Brown | Behavior Technician | 2315 W 2nd St, Marion, IN 46952 | 2019-08-19 |
| 1548767767 | Johnnie Micheal Hiles | Counselor | 315 South Norton Ave., Marion, IN 46952 | 2018-04-13 |
| 1669979936 | Sheila Ann Johnson | Counselor | 315 S. Norton Ave, Marion, IN 46952 | 2018-04-12 |
| 1679070957 | Marissa Lynn Castillo | Counselor | 315 S Norton Avenue, Marion, IN 46952 | 2018-04-12 |
| 1326545609 | Eumalla Lampkins | Case Manager/Care Coordinator | 315 South Norton Avenue, Marion, IN 46952 | 2018-04-12 |
| 1285011650 | Forefront Dermatology, S.c. | Dermatology | 330 N Wabash Ave Ste 360, Marion, IN 46952 | 2015-05-05 |
| 1649510959 | Cancer Services of Grant County Inc. | Prosthetic/Orthotic Supplier | 305 S. Norton Ave., Marion, IN 46952 | 2013-02-22 |
| 1326350844 | Beth Ellen Krouse | Speech-Language Pathologist | 1800 Wabash Ave, Suite 200, Marion, IN 46952 | 2010-07-13 |
| 1093032138 | Thomas Alfred Beck | General Practice | 919 Euclid Avenue, Marion, IN 46952 | 2010-04-29 |
| Find all providers in zip 46952 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740828367 | Kimberly J Lewis | Specialist | 3832 Cory Corners Rd, Marion, NY 14505-9722 | 2019-12-13 |
| 1861829814 | Michael E Steuer, Md, PC | Specialist | 2860 Interstate 55, Ste 7, Marion, AR 72364-2111 | 2013-10-07 |
| 1922376565 | Shannon Lynn White | Specialist | 2513 W 2nd St, Marion, IN 46952-3241 | 2011-12-11 |
| 1689996332 | Southmountain Children and Family Services | Specialist | 81 W Fort St, Marion, NC 28752 | 2010-02-23 |
| 1376743070 | Mcdowell Orthopaedics & Sports Medicine, P.a. | Specialist | 60 S Medical Ct, Marion, NC 28752-4972 | 2007-07-20 |
| 1376759282 | Normal Life of Indiana | Specialist | 201 N Baldwin Ave, Marion, IN 46952-3533 | 2007-05-15 |
| 1285847459 | Marion Pediatric Clinic | Specialist | 31 E Medical Ct Ste 1, Marion, NC 28752-4969 | 2007-05-07 |
| 1720208762 | Elsie Brown | Specialist | 801 W Boulevard St, Marion, IL 62959-1737 | 2007-05-01 |
| 1174684138 | Marion Surgeons, Inc | Specialist | 1395 N Baldwin Ave, Marion, IN 46952-1913 | 2006-12-13 |
| 1467559153 | Charles William Mc Rae | Specialist | 302 Oliver St, Marion, SC 29571-2338 | 2006-09-17 |
| Find all providers in MARION | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.