Healthcare Provider Details

I. General information

NPI: 1154377968
Provider Name (Legal Business Name): RICHARD HOWARD LYERLY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RICK HOWARD LYERLY M.D.

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 05/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 SAINT VINCENTS DR STE. 201
BIRMINGHAM AL
35205-1606
US

IV. Provider business mailing address

PO BOX 830230
BIRMINGHAM AL
35283
US

V. Phone/Fax

Practice location:
  • Phone: 205-250-8946
  • Fax: 205-250-6002
Mailing address:
  • Phone: 205-250-6000
  • Fax: 205-250-6848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number7699
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: