Healthcare Provider Details

I. General information

NPI: 1346860947
Provider Name (Legal Business Name): TIMECERTAIN, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2020
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 S KEYSTONE AVE
INDIANAPOLIS IN
46227-3611
US

IV. Provider business mailing address

1950 W 86TH ST
INDIANAPOLIS IN
46260-2035
US

V. Phone/Fax

Practice location:
  • Phone: 317-925-2200
  • Fax:
Mailing address:
  • Phone: 317-925-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PAUL L WALTON
Title or Position: CEO/OWNER
Credential: MD
Phone: 317-925-2200