MEDICARE: KEJAC VENTURES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	52959

General Provider Information

NPI Number	:	1265919005
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEJAC VENTURES LLC

Provider Business Mailing Address
First Line	:	PO BOX 1051
Second Line	:
City	:	COLLIERVILLE
State	:	TN
Zip	:	38027-1051
Country	:	US
Telephone Number	:	901-761-6157
Fax Number	:	901-761-4145

Provider Business Practice Location Address
First Line	:	6263 POPLAR AVE STE 1052
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38119-4736
Country	:	US
Telephone Number	:	901-761-6157
Fax Number	:	901-761-4145

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	KELECHI UZOMA IWUJI
Credential	:	MD
Telephone Number	:	901-761-6157

Provider Enumeration Date	:	07/24/2018
Last Update Date	:	12/09/2025

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Directions to “KEJAC VENTURES LLC ” Practice Location

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