Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kenneth David Cornwall, OD

Individual provider Optometrist · NPI 1629851886

Kenneth David Cornwall, OD is an Optometry in Smyrna, Georgia. Qualified in 2023, 3 years ago. Licensed in Georgia.

Years since qualifying
3
Licensed in
GA
In the registry since
2023
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

3240 S Cobb Dr SE Ste 1000
Smyrna, GA 30080-4112
Phone: (770) 701-3051
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence OPT003524 (GA)

Record details

NPI number1629851886
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedAugust 14, 2023
Last updated in NPPESAugust 14, 2023
Certification dateAugust 14, 2023
Mailing address2735 Paces Ferry Rd Se Apt 413, Atlanta, GA 30339-7639

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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