# LYERLY BAPTIST INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982437745
- **Authorized official:** TYRONE MCCLOUD (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (904) 202-5367

## Contact information

- **Practice address:** 1747 BAPTIST CLAY DR STE 200, FLEMING ISLAND, FL 32003-8505
- **Practice address phone:** (904) 516-1950
- **Practice address fax:** (904) 376-3062
- **Mailing address:** PO BOX 746647, ATLANTA, GA 30374-6647
- **Mailing address phone:** (904) 202-2092
- **Mailing address fax:** (904) 376-4075

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | NULL | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | — |
| 207T00000X | Neurological Surgery Physician | — | NULL | — |
| 207T00000X | Neurological Surgery Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 08/26/2024
- **Last updated:** 06/02/2026