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Adult & Pediatric Dermatology of Tullahoma PC

NPI #1881658243 in Tullahoma, Tennessee

Provider Information

NPI Number
1881658243
Entity Type
Organization
Organization Name
Adult & Pediatric Dermatology of Tullahoma PC
Primary Specialty
Dermatology
Enumeration Date
Apr 13, 2006
Last Updated
Dec 3, 2009

Practice Location

Address
100 WILLIAM NORTHERN BLVD
Address 2
STE C
City
Tullahoma
State
Tennessee
ZIP Code
37388
Phone
(931) 455-7400

Authorized Official

Name
DR. KEN T TAKEGAMI, MD
Title
PRESIDENT
Phone
(931) 455-7400

Specialties & Taxonomy Codes

Specialty
Dermatology - MOHS-Micrographic Surgery — MOHS-Micrographic Surgery
Dermatology - Dermatopathology — Dermatopathology
Dermatology

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Individual Providers

Provider Name
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Organizations

Provider Name
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