Healthcare Provider Details

I. General information

NPI: 1710077201
Provider Name (Legal Business Name): JAMES MICHAEL KEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: J MIKE KEY MD

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 01/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDREN'S WAY #836
LITTLE ROCK AR
72202
US

IV. Provider business mailing address

1 CHILDRENS WAY # 836
LITTLE ROCK AR
72202-3500
US

V. Phone/Fax

Practice location:
  • Phone: 501-364-1696
  • Fax:
Mailing address:
  • Phone: 501-364-1696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License NumberR-3170
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberR-3170
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: