Provider Demographics
NPI:1942305461
Name:YELAMELI, MADHU SRINIVASAMURTHY (MD)
Entity Type:Individual
Prefix:DR
First Name:MADHU
Middle Name:SRINIVASAMURTHY
Last Name:YELAMELI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 681508
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-1508
Mailing Address - Country:US
Mailing Address - Phone:615-661-7888
Mailing Address - Fax:615-661-9001
Practice Address - Street 1:1040 N. JAMES CAMPBELL BLVD.
Practice Address - Street 2:STE. 108
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401
Practice Address - Country:US
Practice Address - Phone:615-661-7888
Practice Address - Fax:615-661-9001
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000041886207LP2900X
TN41886208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1523457Medicaid