Healthcare Provider Details

I. General information

NPI: 1427753029
Provider Name (Legal Business Name): BLAKELY ALYSSA GRAHAM DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10626 CHAPMAN HWY
SEYMOUR TN
37865-4703
US

IV. Provider business mailing address

1275 DICK LONAS RD
KNOXVILLE TN
37909-1326
US

V. Phone/Fax

Practice location:
  • Phone: 865-577-5231
  • Fax: 833-908-2179
Mailing address:
  • Phone: 865-584-4747
  • Fax: 865-381-1509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number6778
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: