Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gillum Facial Plastic Surgery, PC

Organization Specialist · NPI 1063563617

Gillum Facial Plastic Surgery, PC provides Specialist services in Marion, Indiana. Licensed in Indiana. Registered with an NPI since 2007.

Licensed in
IN
In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

330 N Wabash Ave Ste 210
Marion, IN 46952-2600
Phone: (765) 651-4278
Fax: (765) 664-6445
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 0155912A (IN)

Record details

NPI number1063563617
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy Gillum — Owner · (765) 651-4278
NPI enumeratedJanuary 12, 2007
Last updated in NPPESAugust 22, 2020
Mailing addressPo Box 2063, Indianapolis, IN 46206-2063

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