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General NPI Number Information
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NPI Number | 1922061209
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Entity Type | Individual
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Provider Name | KENNETH MACK NASH O D
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Gender | Male
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Dates
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Enumeration Date | 04/08/2006
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Last Update Date | 11/27/2007
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Provider Practice Location Address
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Address Line | 1001 S MAIN ST
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City | GREENWOOD
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State | SC
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Zip | 29646-3230
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Country | US
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Telephone | 864-388-2020
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Fax | 864-229-5573
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Provider Business Mailing Address
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Address Line | 1001 S MAIN ST PO BOX 1035
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City | GREENWOOD
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State | SC
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Zip | 29646-3230
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Country | US
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Telephone | 864-388-2020
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Fax | 864-229-5573
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 553
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License Number State | SC
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