Provider Demographics
NPI:1063709202
Name:ROBERTSON, SARAH SCALLEY (OD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:SCALLEY
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:RENEE
Other - Last Name:SCALLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:520 WINDING WAY
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1578
Mailing Address - Country:US
Mailing Address - Phone:615-560-3365
Mailing Address - Fax:
Practice Address - Street 1:4030 EASTON STA STE 220
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-7012
Practice Address - Country:US
Practice Address - Phone:614-269-4150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-08
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6069152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist