Gautam Phookan, MD is a medicare enrolled "Neurological Surgery" physician in Muncie, Indiana. His current practice location is
2525 W University Ave Ste 503, Muncie, Indiana. You can reach out to his office (for appointments etc.) via phone at
(765) 288-0441.
Gautam Phookan is licensed to practice in Indiana (license number 01050143A) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1093750978.
Physician's Profile
Full Name | Gautam Phookan |
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Gender | Male |
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Speciality | |
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Experience | Years |
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Location | 2525 W University Ave Ste 503, Muncie, Indiana |
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Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Gautam Phookan attended and graduated from in
NPI Data:
- NPI Number: 1093750978
- Provider Enumeration Date: 06/17/2006
- Last Update Date: 12/16/2022
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Gautam Phookan such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1093750978 | NPI | - | NPPES |
061570015 | Other | IN | MEDICARE |
M22404245 | Other | IN | MEDICARE |
200206470A | Medicaid | IN | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207T00000X | Neurological Surgery | 1050143 (Indiana) | Secondary |
207T00000X | Neurological Surgery | 01050143A (Indiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gautam Phookan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Gautam Phookan, MD 250 N Shadeland Ave, Indianapolis, IN 46219-4959 Ph: () - | Gautam Phookan, MD 2525 W University Ave Ste 503, Muncie, IN 47303-3409 Ph: (765) 288-0441 |
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