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:
Health care specialties
| Specialty | Code | License # | 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 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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