Organization
GALEN MEDICAL GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN WILEY MD (MEDICAL DIRECTOR)
(423) 308-0280
Entity
Organization
Contact information
Practice address
4976 ALPHA LN, HIXSON, TN 37343-5470
(423) 497-5355
(423) 308-0281
Mailing address
4976 ALPHA LN, HIXSON, TN 37343-5470
(423) 497-5355
(423) 308-0281
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0100X
Gastroenterology Physician
—
—
207RI0008X
Hepatology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207W00000X
Ophthalmology Physician
—
—
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
208000000X
Pediatrics Physician
—
—
2080P0201X
Pediatric Allergy/Immunology Physician
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300040275R
—
GA
05
—
3703397
—
TN
Enumeration date
08/08/2006
Last updated
08/12/2024
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