Organization
VRF EYE SPECIALTY GROUP, PLC
Active
Other names
Vitreoretinal Foundation
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUBBA GOLLAMUDI M.D. (CHIEF MANAGER)
(901) 685-2200
Entity
Organization
Contact information
Practice address
825 RIDGE LAKE BLVD, MEMPHIS, TN 38120-9411
(901) 685-2200
(901) 820-2342
Mailing address
825 RIDGE LAKE BLVD, MEMPHIS, TN 38120-9411
(901) 685-2200
(901) 820-2342
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
364S00000X
Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015167
—
MS
05
—
127952002
—
AR
05
—
3383289
—
TN
05
—
506916204
—
MO
Enumeration date
05/20/2006
Last updated
05/19/2020
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