Provider Demographics
NPI:1184617441
Name:BABE, KENNETH STEWART JR (MD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:STEWART
Last Name:BABE
Suffix:JR
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 1:528 HARTSVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-2450
Mailing Address - Country:US
Mailing Address - Phone:615-547-4310
Mailing Address - Fax:615-547-4306
Practice Address - Street 1:528 HARTSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-2450
Practice Address - Country:US
Practice Address - Phone:615-480-3205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000028968207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3812714Medicare ID - Type UnspecifiedINDIVIDUAL
TNG49124Medicare UPIN
TN3376212Medicare ID - Type UnspecifiedGROUP