Provider Demographics
NPI:1922020064
Name:DYSON, SARAH JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:JEAN
Last Name:DYSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JEAN
Other - Last Name:SEEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:901 PATIENTS FIRST DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-4700
Mailing Address - Country:US
Mailing Address - Phone:636-239-7500
Mailing Address - Fax:636-239-2836
Practice Address - Street 1:901 PATIENTS FIRST DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-4700
Practice Address - Country:US
Practice Address - Phone:636-239-7500
Practice Address - Fax:636-239-2836
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004007505207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208454504Medicaid
MOP01135249OtherRAILROAD MEDICAR
MO1922020064Medicaid
P00430672OtherRAILROAD MEDICARE
MO1922020064Medicaid
925002943Medicare Oscar/Certification
925002943Medicare PIN
MO208454504Medicaid