Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 28207 | KY |
NPI | 1003912783 |
---|---|
Provider Name | Michael Don Canty |
First Address | Ashland, KY 41101-2845 |
Second Address | Ashland, KY 41101-2845 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 06/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000049731 | ANTHEM INSURANCE (01) | |
64282072 | (05) | KY |
E93996 | (02) |