Provider Demographics
NPI:1154377968
Name:LYERLY, RICHARD HOWARD (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:HOWARD
Last Name:LYERLY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RICK
Other - Middle Name:HOWARD
Other - Last Name:LYERLY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 830230
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35283
Mailing Address - Country:US
Mailing Address - Phone:205-250-6000
Mailing Address - Fax:205-250-6848
Practice Address - Street 1:833 SAINT VINCENTS DR
Practice Address - Street 2:STE. 201
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1606
Practice Address - Country:US
Practice Address - Phone:205-250-8946
Practice Address - Fax:205-250-6002
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7699207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000005711Medicaid
ALC73657Medicare UPIN
AL000005711Medicaid