Provider Demographics
NPI:1609404490
Name:SOKAN, BABAJIMI ARAYO (MD)
Entity Type:Individual
Prefix:
First Name:BABAJIMI
Middle Name:ARAYO
Last Name:SOKAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 S JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-2638
Mailing Address - Country:US
Mailing Address - Phone:859-684-7852
Mailing Address - Fax:
Practice Address - Street 1:2800 BRECKENRIDGE LN STE 310
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-1402
Practice Address - Country:US
Practice Address - Phone:502-928-5000
Practice Address - Fax:502-928-5001
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-29
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KYTP683207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program