| Doctor Name: | DR. KEVIN TYLER NASH |
| NPI Number: | 1326201856 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 4301092081 |
| Business Practice Address: | 308 Coliseum Dr Suite 200 Macon, GA - 312173865 |
| Business Phone Number: | 4787422180 |
| Business Fax Number: | 4787452623 |
| Mailing Address: | 308 Coliseum Drive, Suite 200 MACON |
| State: | GA |
| Postal Code: | 312173861 |
| Phone Number: | 4787422180 |
| Fax Number: | 4787452623 |
| NPI Enumeration Date: | 07/03/2008 |
| NPI Last Update Date: | 04/29/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | 4301092081 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |