Provider Demographics
NPI:1619553534
Name:BENNETT LEVI, KATELYN RENEE (DO)
Entity type:Individual
Prefix:DR
First Name:KATELYN
Middle Name:RENEE
Last Name:BENNETT LEVI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5131 BEACON HILL RD STE 120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-4442
Mailing Address - Country:US
Mailing Address - Phone:614-544-1994
Mailing Address - Fax:614-544-0052
Practice Address - Street 1:5131 BEACON HILL RD STE 120
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-4442
Practice Address - Country:US
Practice Address - Phone:614-544-1994
Practice Address - Fax:614-544-0052
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.017045207R00000X, 208M00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist