Healthcare Provider Details

I. General information

NPI: 1104850130
Provider Name (Legal Business Name): HEIKKI E KOSTAMAA MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 02/12/2023
Certification Date: 02/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 WHITE BRIDGE PIKE STE. 208
NASHVILLE TN
37205
US

IV. Provider business mailing address

341 COOL SPRINGS BLVD. STE. 400
FRANKLIN TN
37067
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-2001
  • Fax: 615-327-2015
Mailing address:
  • Phone: 423-508-7337
  • Fax: 423-508-7338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number39604
License Number StateTN

VIII. Authorized Official

Name: DR. HEIKKI E KOSTAMAA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 615-327-2001