Healthcare Provider Details

I. General information

NPI: 1356318216
Provider Name (Legal Business Name): LYRAD K RILEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2698 PATTERSON RD
GRAND JUNCTION CO
81506-8818
US

IV. Provider business mailing address

2698 PATTERSON RD
GRAND JUNCTION CO
81506-8818
US

V. Phone/Fax

Practice location:
  • Phone: 970-298-2800
  • Fax: 970-298-6902
Mailing address:
  • Phone: 970-298-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberCDRH.0058788
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA66582
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: