Provider Demographics
NPI:1841647583
Name:DILLEHAY, SALLY MARIE (OD, MS, EDD)
Entity type:Individual
Prefix:DR
First Name:SALLY
Middle Name:MARIE
Last Name:DILLEHAY
Suffix:
Gender:F
Credentials:OD, MS, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 BUCKINGHAM FOREST CT
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-6312
Mailing Address - Country:US
Mailing Address - Phone:770-596-5417
Mailing Address - Fax:
Practice Address - Street 1:901 ABERNATHY RD STE 100
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-2561
Practice Address - Country:US
Practice Address - Phone:404-752-1702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002928152WC0802X
OHOH-3852-T408152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152W00000XEye and Vision Services ProvidersOptometrist