Takegami, Ken T

Takegami, Ken T is an individual health care provider with primary practice located at 100 William Northern Blvd Suite C, Tullahoma TN 37388. He recently has 4 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 / Procedural Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Takegami, Ken T can be contacted via phone (931) 455-7400.

Contact Information

Primary practice address
100 William Northern Blvd Suite C Tullahoma TN 37388
Phone: (931) 455-7400
Fax: (931) 455-6344
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X MD021099 Tennessee
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X MD0000021099 Tennessee
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X MD0000021099 Tennessee
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X MD0000021099 Tennessee

Profile Details

NPI number 1932251873
LBN Legal business name Takegami, Ken T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2007
Last updated Dec 4th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932251873 NPPES
Tennessee Other 3063983 BCBS OF TENNESSEE
Tennessee Other 3075822 BCBS OF TENNESSEE
Tennessee MEDICAID 3373903 BCBS OF TENNESSEE

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