| Organization Name: | KJ MEDICAL MANAGEMENT |
| NPI Number: | 1144628983 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN C WARE (ADMINISTRATOR) |
| Mailing Address: | 11215 Hermitage Rd Ste 201 Little Rock |
| State: | AR US |
| Postal Code: | 722113809 |
| Phone Number: | 5014148218 |
| Fax Number: | |
| NPI Enumeration Date: | 12/10/2014 |
| NPI Last Update Date: | 12/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
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Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |