Healthcare Provider Details

I. General information

NPI: 1245275379
Provider Name (Legal Business Name): GARY KANTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 05/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6903 BURLINGTON PIKE
FLORENCE KY
41042-1618
US

IV. Provider business mailing address

6903 BURLINGTON PIKE
FLORENCE KY
41042-1618
US

V. Phone/Fax

Practice location:
  • Phone: 859-282-6700
  • Fax: 859-282-6760
Mailing address:
  • Phone: 859-282-6700
  • Fax: 859-282-6760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number22876
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: