Healthcare Provider Details

I. General information

NPI: 1043313984
Provider Name (Legal Business Name): JASON S NASH OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 06/02/2021
Certification Date: 06/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 ADAMS DR
FAIRVIEW TN
37062-7237
US

IV. Provider business mailing address

7100 ADAMS DR
FAIRVIEW TN
37062-7237
US

V. Phone/Fax

Practice location:
  • Phone: 615-799-8439
  • Fax: 615-799-7894
Mailing address:
  • Phone: 615-799-8439
  • Fax: 615-799-7894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2531
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: