Adult & Pediatric Dermatology Of Tullahoma Pc
LBN: Adult & Pediatric Dermatology Of Tullahoma Pc
Adult & Pediatric Dermatology Of Tullahoma Pc is an health care organization with primary practice located at 100 William Northern Blvd Ste C, Tullahoma TN 37388. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Dermatology is the primary health care specialty.
Adult & Pediatric Dermatology Of Tullahoma Pc can be contacted via phone (931) 455-7400, or through Takegami, Ken T via phone (931) 455-7400.
Contact Information
Primary practice address
100 William Northern Blvd Ste C
Tullahoma TN 37388
Phone: (931) 455-7400
Fax: (931) 455-6344
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | MD0000021099 | Tennessee |
| Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | MD0000021099 | Tennessee |
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ND0900X | MD0000021099 | Tennessee |
Profile Details
| NPI number | 1881658243 |
|---|---|
| LBN Legal business name | Adult & Pediatric Dermatology Of Tullahoma Pc |
| DBA Doing business as | |
| Authorized official | Takegami, Ken T Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 13th, 2006 |
| Last updated | Dec 3rd, 2009 - about 15 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881658243 | NPPES |
| Tennessee | MEDICAID | 3373903 |
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