Healthcare Provider Details

I. General information

NPI: 1790785491
Provider Name (Legal Business Name): JAMES R GALYEAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 01/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 UNION AVE
MEMPHIS TN
38104-3415
US

IV. Provider business mailing address

5885 AIRLINE RD UNIT 985
ARLINGTON TN
38002-5121
US

V. Phone/Fax

Practice location:
  • Phone: 901-317-7427
  • Fax: 901-317-7843
Mailing address:
  • Phone: 901-317-7360
  • Fax: 901-317-7585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number11434
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: