Dutta, Gautam

Dutta, Gautam is an individual health care provider with primary practice located at 1 Medical Center Blvd Suite 103, Cookeville TN 38501-4294. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hospitalist, which is considered as his primary health care specialty. Dutta, Gautam can be contacted via phone (931) 783-2770.

Contact Information

Primary practice address
1 Medical Center Blvd Suite 103 Cookeville TN 38501-4294
Phone: (931) 783-2770
Fax: (931) 525-1176
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X MD45220 Tennessee

Profile Details

NPI number 1245352970
LBN Legal business name Dutta, Gautam
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2007
Last updated Dec 29th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1245352970 NPPES
Tennessee MEDICAID 1516195

Popular Providers