Healthcare Provider Details

I. General information

NPI: 1669899142
Provider Name (Legal Business Name): CHARLES EDWARD GALYON PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2014
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9047 EXECUTIVE PARK DR STE 210
KNOXVILLE TN
37923-4625
US

IV. Provider business mailing address

9038 CROSS PARK DR STE 105
KNOXVILLE TN
37923-4720
US

V. Phone/Fax

Practice location:
  • Phone: 865-983-1899
  • Fax:
Mailing address:
  • Phone: 865-983-1899
  • Fax: 865-223-5777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number3177
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: