Healthcare Provider Details

I. General information

NPI: 1841995719
Provider Name (Legal Business Name): COLBY CANTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2023
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 PROSPEROUS PL STE 100
LEXINGTON KY
40509-1866
US

IV. Provider business mailing address

120 PROSPEROUS PL STE 100
LEXINGTON KY
40509-1866
US

V. Phone/Fax

Practice location:
  • Phone: 859-543-4340
  • Fax: 859-543-4349
Mailing address:
  • Phone: 859-543-4340
  • Fax: 859-543-4349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number62015
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: