Tullahoma Dermatology PC
NPI 1154948669ActiveOrganization· Dermatology· Tullahoma, TN
Dermatology in Tullahoma, Tennessee, registered in NPPES in June 2020. The authorized official on file is Isaac Bryan, President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1154948669 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 30, 2020 |
| Last updated in NPPES | Jun 30, 2020 |
| Certified by provider | Jun 30, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TN) |
|---|
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