Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Adult & Pediatric Dermatology of Tullahoma PC

Organization Dermatology Physician · NPI 1881658243

Adult & Pediatric Dermatology of Tullahoma PC is a Dermatology Physician in Tullahoma, Tennessee. Licensed in Tennessee. Registered with an NPI since 2006.

Licensed in
TN
In the registry since
2006
Specialties on file
3
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

100 William Northern Blvd Ste C
Tullahoma, TN 37388
Phone: (931) 455-7400
Fax: (931) 455-6344
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence MD0000021099 (TN)
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X · Licence MD0000021099 (TN)
Dermatopathology Physician Taxonomy 207ND0900X · Licence MD0000021099 (TN)

Record details

NPI number1881658243
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ken Takegami — President · (931) 455-7400
NPI enumeratedApril 13, 2006
Last updated in NPPESDecember 3, 2009
Mailing address100 William Northern Blvd, Ste C, Tullahoma, TN 37388

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