ADULT & PEDIATRIC DERMATOLOGY OF TULLAHOMA PC
NPI 1881658243
Dermatology in Tullahoma, TN

Q: What is Adult & Pediatric Dermatology Of Tullahoma PC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Active since April 13, 2006

100 WILLIAM NORTHERN BLVD, STE C, TULLAHOMA, TN 37388(931) 455-7400(931) 455-6344 Get Directions Write a Review

NPPES record last updated: December 3, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Adult & Pediatric Dermatology Of Tullahoma Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADULT & PEDIATRIC DERMATOLOGY OF TULLAHOMA PC (NPI 1881658243) is a healthcare organization registered as a dermatology in Tullahoma, Tennessee and active in the NPI registry since April 2006. The organization lists Ken T Takegami, President, as its authorized official.

NPPES Registry Identity

NPI1881658243

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NameADULT & PEDIATRIC DERMATOLOGY OF TULLAHOMA PC

Location Address100 WILLIAM NORTHERN BLVD, STE CTullahoma, TN 37388

Mailing Address100 William Northern Blvd, Ste CTullahoma, TN 37388 · (931) 455-7400 · Fax (931) 455-6344

Phone(931) 455-7400

Fax(931) 455-6344

Organization SubpartNo

Authorized OfficialKen T TakegamiPresident · (931) 455-7400

Enumeration DateApril 13, 2006

Last NPPES UpdateDecember 3, 2009

✔ NPI 1881658243 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

License✔ Licensed in TN · MD0000021099

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X · License MD0000021099 (TN)

Also ListedDermatology · DermatopathologyTaxonomy 207ND0900X · License MD0000021099 (TN)

100 WILLIAM NORTHERN BLVD, Tullahoma, TN 37388

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Other Identifiers 3

Medicare UPINF59650

Medicaid3373903TN

Medicare ID-Type Unspecified3373903TN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. TARA BETH TYE NP-C

Nurse Practitioner (Family)