Organization
VRF EYE SPECIALTY GROUP, PLC
Active
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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