| Lyerly Baptist Inc | |
|
14546 Old Saint Augustine Rd Ste 409 Jacksonville FL 32258-5473 | |
| (904) 388-6518 | |
| (904) 384-1005 |
| Full Name | Lyerly Baptist Inc |
|---|---|
| Speciality | Neurological Surgery |
| Location | 14546 Old Saint Augustine Rd Ste 409, Jacksonville, Florida |
| Authorized Official Name and Position | Edward J. Gorak (VP, MEDICAL DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 9042027300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lyerly Baptist Inc Po Box 746647 Atlanta GA 30374-6647 Ph: (904) 202-2092 | Lyerly Baptist Inc 14546 Old Saint Augustine Rd Ste 409 Jacksonville FL 32258-5473 Ph: (904) 388-6518 |
| NPI Number | 1720869068 |
|---|---|
| Provider Enumeration Date | 10/12/2023 |
| Last Update Date | 08/26/2024 |
| Certification Date | 08/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720869068 | NPI | - | NPPES |
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