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NPI Code Detail

MEDICARE: RALPH THOMAS LYERLY JR. M.D.

MEDICARE:   RALPH THOMAS LYERLY JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician5666AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578516076
Entity Type Code : Individual
Provider Name (Legal Business Name) : RALPH THOMAS LYERLY JR. M.D.
Provider Business Mailing Address
First Line : 3400 HIGHWAY 78 E
Second Line : MEDICAL ARTS TOWER, SUITE 406
City : TALLADEGA
State : AL
Zip : 35501
Country : US
Telephone Number : 205-384-4212
Fax Number : 205-387-8130
Provider Business Practice Location Address
First Line : 1532 CARRAWAY BLVD
Second Line : SUITE 220
City : BIRMINGHAM
State : AL
Zip : 35234-1955
Country : US
Telephone Number : 205-502-1700
Fax Number : 205-502-1710
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2006
Last Update Date : 02/05/2018

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