Subba R Gollamudi, M.D.

Ophthalmology in Memphis, TN. Individual provider (NPI-1).

NPI number1154378735

StatusActive

Last updated in NPPESJul 25, 2022

Details

NPI: 1154378735
Entity type: Individual (NPI-1)
Name: Subba R Gollamudi
Credential: M.D.
Sex: Male
Sole proprietor: No
Enumeration date: May 28, 2006
Certification date: Jul 25, 2022
Last updated: Jul 25, 2022

Medicare and OIG

Medicare enrolled (PECOS): Yes · PRACTITIONER - OPHTHALMOLOGY
Can order and refer: Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207W00000X	Ophthalmology	MD0000021892	TN	Yes
207W00000X	Ophthalmology	E-3527	AR
207W00000X	Ophthalmology	16734	MS

Practice location

825 Ridge Lake Blvd
Memphis, TN 38120-9411

Phone 901-685-2200 · Fax 901-820-2342

Mailing address

Po Box 22510
Jackson, MS 39225-2510

Phone 901-685-2200 · Fax 901-255-5631

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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Ophthalmology Physician providers in Memphis, TN

All 78 Ophthalmology Physician providers in Memphis · All 16,727 providers in Memphis

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