Provider Demographics
NPI:1255493342
Name:MYERS, LYLE CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:LYLE
Middle Name:CHRISTOPHER
Last Name:MYERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3340 BRIGHTON PLACE DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2315
Mailing Address - Country:US
Mailing Address - Phone:859-229-9527
Mailing Address - Fax:
Practice Address - Street 1:3340 BRIGHTON PLACE DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2315
Practice Address - Country:US
Practice Address - Phone:859-229-9527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY30815207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY88140OtherCHA
460001484OtherRAILROAD MEDICARE
KY000000041604OtherANTHEM BCBS
KYF92909OtherBLUEGRASS FAMILY HEALTH
KY64308158Medicaid
KYF92909OtherBLUEGRASS FAMILY HEALTH
KY000000041604OtherANTHEM BCBS