Healthcare Provider Details

I. General information

NPI: 1033147491
Provider Name (Legal Business Name): SCOTT BRIAN BABIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 BLUEGRASS AVE
LOUISVILLE KY
40215-1161
US

IV. Provider business mailing address

PO BOX 11087
KNOXVILLE TN
37939-1087
US

V. Phone/Fax

Practice location:
  • Phone: 865-584-7376
  • Fax: 865-540-3856
Mailing address:
  • Phone: 865-584-7376
  • Fax: 865-540-3856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number35069
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number35069
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number35069
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number35069
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: