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Organization

LYERLY BAPTIST INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TYRONE MCCLOUD (EXECUTIVE DIRECTOR)
(904) 388-6518
Entity
Organization

Contact information

Practice address
836 PRUDENTIAL DR STE 1400, JACKSONVILLE, FL 32207-8340
(904) 388-6518
(904) 384-1005
Mailing address
PO BOX 746647, ATLANTA, GA 30374-6647
(904) 202-2092
(904) 376-4075

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
2084N0400X
Neurology Physician

Other

Enumeration date
10/05/2009
Last updated
03/03/2026
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