OrganizationActive
Adult & Pediatric Dermatology of Tullahoma PC
NPI 1881658243 · Dermatology Physician · Tullahoma, TN
Provider details
- NPI number
- 1881658243
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ken Takegami, President(931) 455-7400
- License
- MD0000021099 (TN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
100 William Northern Blvd
Ste C
Tullahoma, TN 37388
Phone: (931) 455-7400
Fax: (931) 455-6344
Approximate (ZIP-level) locationGet directions
Mailing address
100 William Northern Blvd
Tullahoma, TN 37388
Registry dates
- Enumerated
- 2006-04-13
- Last updated
- 2009-12-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.