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

Gautam Phookan, MD

Individual provider Neurological Surgery Physician · NPI 1093750978

Gautam Phookan, MD is a Neurological Surgery Physician in Muncie, Indiana. Licensed in Indiana. Registered with an NPI since 2006.

Licensed in
IN
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2525 W University Ave Ste 503
Muncie, IN 47303-3409
Phone: (765) 288-0441
Fax: (765) 282-7879
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurological Surgery Physician (primary) Taxonomy 207T00000X · Licence 01050143A (IN)
Neurological Surgery Physician Taxonomy 207T00000X · Licence 1050143 (IN)

Record details

NPI number1093750978
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 17, 2006
Last updated in NPPESDecember 16, 2022
Certification dateDecember 16, 2022
Mailing address250 N Shadeland Ave, Indianapolis, IN 46219-4959

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