Healthcare Provider Details

I. General information

NPI: 1639225519
Provider Name (Legal Business Name): TIMOTHY F BURNS M.D. PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W 10TH AVE
COLUMBUS OH
43210-1280
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-5066
  • Fax: 614-293-9449
Mailing address:
  • Phone: 614-293-5066
  • Fax: 614-293-9449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD445729
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD445729
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number35.152226
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: