Provider Demographics
NPI:1548290844
Name:LYERLY, RALPH THOMAS III (MD)
Entity type:Individual
Prefix:
First Name:RALPH
Middle Name:THOMAS
Last Name:LYERLY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2151 OLD ROCKY RIDGE RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-7235
Mailing Address - Country:US
Mailing Address - Phone:205-989-1080
Mailing Address - Fax:
Practice Address - Street 1:2010 BROOKWOOD MEDICAL CTR DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6804
Practice Address - Country:US
Practice Address - Phone:205-989-1080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.24332207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL010033CI28786OtherSECTION 1011
AL051527921OtherBLUE CROSS
ALP00255687OtherRAILROAD MEDICARE
AL051527917OtherBLUE CROSS
AL106490Medicaid
AL009994915Medicaid
AL009994925Medicaid
AL051527919OtherBLUE CROSS
AL009994935Medicaid
MS01231508OtherMISSISSIPPI MEDICAID
AL009994925Medicaid
AL009994925Medicaid