Healthcare Provider Details

I. General information

NPI: 1083296149
Provider Name (Legal Business Name): BRENNAN SCOTT NOEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2021
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 ROSE STREET
LEXINGTON KY
40536-0001
US

IV. Provider business mailing address

780 ROSE STREET ROOM M53
LEXINGTON KY
40536-0001
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5083
  • Fax:
Mailing address:
  • Phone: 859-323-5083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberTP956
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: