Provider Demographics
NPI:1912427923
Name:LEVITT, KYLE C (DO)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:C
Last Name:LEVITT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 COPPERFIELD BLVD NE STE 202
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2441
Mailing Address - Country:US
Mailing Address - Phone:704-403-0463
Mailing Address - Fax:
Practice Address - Street 1:1210 NEW GARDEN RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2721
Practice Address - Country:US
Practice Address - Phone:336-294-6190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-21
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC228147207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine