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GILLUM FACIAL PLASTIC SURGERY, PC
NPI 1063563617
Specialist in Marion, IN

Active since January 12, 2007CLIA 15D2148851 · Waiver
330 N WABASH AVE, STE 210, MARION, IN 46952(765) 651-4278(765) 664-6445 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Gillum Facial Plastic Surgery, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GILLUM FACIAL PLASTIC SURGERY, PC (NPI 1063563617) is a healthcare organization registered as a specialist in Marion, Indiana and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through May 20, 2028 and lists Timothy G Gillum, Owner, as its authorized official.

NPPES Registry Identity

NPI1063563617
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameGILLUM FACIAL PLASTIC SURGERY, PC
Location Address330 N WABASH AVE, STE 210Marion, IN 46952-2600
Mailing AddressPo Box 2063Indianapolis, IN 46206-2063 · (765) 651-4278 · Fax (765) 664-6445
Phone(765) 651-4278
Fax(765) 664-6445
Organization SubpartNo
Authorized OfficialTimothy G GillumOwner · (765) 651-4278
Enumeration DateJanuary 12, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1063563617 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in IN · 0155912A
Definition
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.
330 N WABASH AVE, Marion, IN 46952
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D2148851

Gillum Facial Plastic Surgery-D/B/A Gillum Sinus & Allergy · Marion, IN
Active · expires May 20, 2028
CLIA Number15D2148851
Laboratory TypePhysician Office
Certificate Effective DateMay 21, 2026
Certificate Expiration DateMay 20, 2028
Laboratory DirectorTimothy G. Gillum
Laboratory Phone(765) 651-4278
Laboratory LocationGillum Facial Plastic Surgery-D/B/A Gillum Sinus & Allergy801 W Gardner Dr, Marion, IN 46952
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTINE A HESS MD
Dermatology
330 N WABASH AVE, #360
MARION, IN 46952
Grant County (765) 664-3292
DR. SARAH OLIVIA LINGO AU.D.
Audiologist
330 N WABASH AVE, SUITE 210
MARION, IN 46952
Grant County (765) 651-4278
DR. DAVID GORDON ROE M.D.
Surgery
330 N WABASH AVE, SUITE 440
MARION, IN 46952
Grant County (765) 664-7401
EMILY BARRIDO-KABIGTING MD
Pediatrics
330 N WABASH AVE, STE 320
MARION, IN 46952
Grant County (765) 660-7660
SURGICAL ASSOCIATES PC
Surgery
330 N WABASH AVE, SUITE 440
MARION, IN 46952
Grant County (765) 664-7401
PATIENTFIRST MEDICAL GROUP OF MGH
Preventive Medicine (Occupational Medicine)
330 N WABASH AVE, SUITE 110
MARION, IN 46952
Grant County (765) 662-4198
MARION GENERAL HOSPITAL
Pediatrics
330 N WABASH AVE, SUITE 320
MARION, IN 46952
Grant County (765) 660-7660
MIDWEST ALLERGY & SINUS CENTER, LLC
Clinic/Center
330 N WABASH AVE, SUITE 210
MARION, IN 46952
Grant County (765) 651-4248

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gillum Facial Plastic Surgery, PC's NPI number?

The NPI number for Gillum Facial Plastic Surgery, PC is 1063563617. It was assigned to this organization in the NPPES registry on January 12, 2007.

Where is Gillum Facial Plastic Surgery, PC located?

Gillum Facial Plastic Surgery, PC is located at 330 N Wabash Ave Ste 210, Marion, IN 46952. The listed phone number is (765) 651-4278.

What is Gillum Facial Plastic Surgery, PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Gillum Facial Plastic Surgery, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2148851) is associated with this NPI, valid through May 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Gillum Facial Plastic Surgery, PC accept?

Health plans from Anthem Blue Cross and Blue Shield and CareSource list Gillum Facial Plastic Surgery, PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Gillum Facial Plastic Surgery, PC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.