Provider Demographics
NPI:1790785491
Name:GALYEAN, JAMES R (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:GALYEAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5885 AIRLINE RD UNIT 985
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-5121
Mailing Address - Country:US
Mailing Address - Phone:901-317-7360
Mailing Address - Fax:901-317-7585
Practice Address - Street 1:1265 UNION AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3415
Practice Address - Country:US
Practice Address - Phone:901-317-7427
Practice Address - Fax:901-317-7843
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2016-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN11434207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3172025Medicaid
TN102I069503Medicare PIN
TN3172025Medicaid