Provider Demographics
NPI:1104850130
Name:HEIKKI E KOSTAMAA MD PC
Entity Type:Organization
Organization Name:HEIKKI E KOSTAMAA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HEIKKI
Authorized Official - Middle Name:E
Authorized Official - Last Name:KOSTAMAA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-327-2001
Mailing Address - Street 1:341 COOL SPRINGS BLVD.
Mailing Address - Street 2:STE. 400
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067
Mailing Address - Country:US
Mailing Address - Phone:423-508-7337
Mailing Address - Fax:423-508-7338
Practice Address - Street 1:28 WHITE BRIDGE PIKE
Practice Address - Street 2:STE. 208
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205
Practice Address - Country:US
Practice Address - Phone:615-327-2001
Practice Address - Fax:615-327-2015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2023-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39604207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH87396Medicare UPIN
TN3731475Medicare ID - Type Unspecified