Provider Demographics
NPI:1598225567
Name:LOGOTHETIS, CONSTANTINE (MD)
Entity type:Individual
Prefix:
First Name:CONSTANTINE
Middle Name:
Last Name:LOGOTHETIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:COSTA
Other - Middle Name:
Other - Last Name:LOGOTHETIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2004 HAYES ST STE 800
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2659
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2004 HAYES ST STE 800
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2659
Practice Address - Country:US
Practice Address - Phone:877-836-6662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-24
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TN74165207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program