| Kejac Ventures Llc | |
|
2986 Kate Bond Rd Bartlett TN 38133-4003 | |
| (901) 820-7000 | |
| Not Available |
| Full Name | Kejac Ventures Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2986 Kate Bond Rd, Bartlett, Tennessee |
| Authorized Official Name and Position | Kelechi Uzoma Iwuji (MANAGER) |
| Authorized Official Contact | 2487471735 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kejac Ventures Llc 9390 Mayfield Rd S Collierville TN 38017-3354 Ph: (248) 747-1735 | Kejac Ventures Llc 2986 Kate Bond Rd Bartlett TN 38133-4003 Ph: (901) 820-7000 |
| NPI Number | 1265919005 |
|---|---|
| Provider Enumeration Date | 07/24/2018 |
| Last Update Date | 07/24/2018 |
| Medicare PECOS PAC ID | 9335490325 |
|---|---|
| Medicare Enrollment ID | O20181002001250 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265919005 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 52959 (* (Not Available)) | Primary |
| Provider Name | Kelechi U Iwuji |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548524861 PECOS PAC ID: 6709190465 Enrollment ID: I20150810000172 |
| Provider Name | Jacinta Iwuji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578921698 PECOS PAC ID: 9234419151 Enrollment ID: I20181023001468 |
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