MEDICARE: LARRY KEVIN NASH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	68078	GA

General Provider Information

NPI Number	:	1245221183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY KEVIN NASH M.D.

Provider Business Mailing Address
First Line	:	PO BOX 15849
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31416-2549
Country	:	US
Telephone Number	:	912-819-5999
Fax Number	:	912-819-5980

Provider Business Practice Location Address
First Line	:	5354 REYNOLDS ST STE 424
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31405-6011
Country	:	US
Telephone Number	:	912-819-5999
Fax Number	:	912-819-5999

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	03/03/2025

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