Provider Demographics
NPI:1730304874
Name:DYSON, CORI ANNE (MD)
Entity Type:Individual
Prefix:MS
First Name:CORI
Middle Name:ANNE
Last Name:DYSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CORI
Other - Middle Name:ANNE
Other - Last Name:BURDINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:P.O. BOX 17253
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72403
Mailing Address - Country:US
Mailing Address - Phone:870-972-1497
Mailing Address - Fax:866-422-5771
Practice Address - Street 1:820 EAST MATTHEWS
Practice Address - Street 2:SUITE F
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401
Practice Address - Country:US
Practice Address - Phone:870-972-1497
Practice Address - Fax:866-422-5771
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-53052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry