Provider Demographics
NPI:1578516076
Name:LYERLY, RALPH THOMAS JR (MD)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:THOMAS
Last Name:LYERLY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3400 HIGHWAY 78 E
Mailing Address - Street 2:MEDICAL ARTS TOWER, SUITE 406
Mailing Address - City:TALLADEGA
Mailing Address - State:AL
Mailing Address - Zip Code:35501
Mailing Address - Country:US
Mailing Address - Phone:205-384-4212
Mailing Address - Fax:205-387-8130
Practice Address - Street 1:1532 CARRAWAY BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35234-1955
Practice Address - Country:US
Practice Address - Phone:205-502-1700
Practice Address - Fax:205-502-1710
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2018-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL5666207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000043862Medicaid
AL510I100007Medicare PIN
ALC72966Medicare UPIN