Basic Information
| Provider Information | |||||||||
| NPI: | 1548290844 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LYERLY | ||||||||
| FirstName: | RALPH | ||||||||
| MiddleName: | THOMAS | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | III | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2151 OLD ROCKY RIDGE RD | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352167235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059891080 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2010 BROOKWOOD MEDICAL CTR DR | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352096804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059891080 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2006 | ||||||||
| LastUpdateDate: | 09/08/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | MD.24332 | AL | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 010033CI28786 | 01 | AL | SECTION 1011 | OTHER | 051527921 | 01 | AL | BLUE CROSS | OTHER | P00255687 | 01 | AL | RAILROAD MEDICARE | OTHER | 051527917 | 01 | AL | BLUE CROSS | OTHER | 106490 | 05 | AL | MEDICAID | 009994915 | 05 | AL | MEDICAID | 009994925 | 05 | AL | MEDICAID | 051527919 | 01 | AL | BLUE CROSS | OTHER | 009994935 | 05 | AL | MEDICAID | 01231508 | 01 | MS | MISSISSIPPI MEDICAID | OTHER |