Healthcare Provider Details

I. General information

NPI: 1801706171
Provider Name (Legal Business Name): PRESLEY DYE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2409 N PATTERSON ST STE 230
VALDOSTA GA
31602-2512
US

IV. Provider business mailing address

2409 N PATTERSON ST STE 230
VALDOSTA GA
31602-2512
US

V. Phone/Fax

Practice location:
  • Phone: 229-259-4369
  • Fax: 229-259-4369
Mailing address:
  • Phone: 229-259-4369
  • Fax: 229-259-4369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: