Healthcare Provider Details

I. General information

NPI: 1356158018
Provider Name (Legal Business Name): TIMOTHY BUNCH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2024
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1218 N MAIN ST
RUSHVILLE IN
46173-1114
US

IV. Provider business mailing address

920 COUNTY LINE RD
BATESVILLE IN
47006-9008
US

V. Phone/Fax

Practice location:
  • Phone: 765-745-8053
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: