Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gautam Dutta

Individual provider Hospitalist Physician · NPI 1245352970

Gautam Dutta is an Internal Medicine in Cookeville, Tennessee. Qualified in 1994, 32 years ago. Practices with Kaiser Foundation Health Plan of the Mid Atlantic States, Inc, a 1,934-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
32
Licensed in
TN
In the registry since
2007
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Practice location Address checks out

1 Medical Center Blvd Ste 103
Cookeville, TN 38501-4294
Phone: (931) 783-2770
Fax: (931) 525-1176
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Hospitalist Physician (primary) Taxonomy 208M00000X · Licence MD45220 (TN)

Record details

NPI number1245352970
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 4, 2007
Last updated in NPPESDecember 29, 2021
Certification dateDecember 29, 2021
Mailing address127 N Oak Ave, Suite D, Cookeville, TN 38501-2435

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 1994 (32 years in practice)
Group practice Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc — 1934 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Cookeville