Provider Demographics
NPI:1952968380
Name:DYSON, AARON
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:DYSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 COMMUNITY DR APT 402
Mailing Address - Street 2:
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-6715
Mailing Address - Country:US
Mailing Address - Phone:562-522-3026
Mailing Address - Fax:
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-400-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-21
Last Update Date:2023-06-23
Deactivation Date:2023-03-28
Deactivation Code:
Reactivation Date:2023-05-10
Provider Licenses
StateLicense IDTaxonomies
103K00000X
IAR-12987207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst