Provider Demographics
NPI:1881851848
Name:BENNETT, KYLA M (MD)
Entity Type:Individual
Prefix:
First Name:KYLA
Middle Name:M
Last Name:BENNETT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:608-829-5485
Mailing Address - Fax:
Practice Address - Street 1:451 JUNCTION RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-2656
Practice Address - Country:US
Practice Address - Phone:608-263-8915
Practice Address - Fax:608-265-5722
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI63841-202086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery