Individual
JONATHAN A DYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1101 HOSPITAL DR, COLUMBIA, MO 65212-0001
(573) 882-4800
(573) 884-5947
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2001014980
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
189164
BLUE SHIELD/BLUE CHOICE
MO
05
—
209312404
—
MO
01
—
300639
UNITED HEALTHCARE
MO
01
—
658400
HEALTHLINK
MO
Enumeration date
05/04/2006
Last updated
09/14/2022
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