Provider Demographics
NPI:1477292563
Name:BADGER, KAMDEN MACHELLE (OD)
Entity Type:Individual
Prefix:
First Name:KAMDEN
Middle Name:MACHELLE
Last Name:BADGER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:738 300TH ST
Mailing Address - Street 2:
Mailing Address - City:BAGLEY
Mailing Address - State:IA
Mailing Address - Zip Code:50026-8016
Mailing Address - Country:US
Mailing Address - Phone:515-370-5548
Mailing Address - Fax:
Practice Address - Street 1:4626 MILL BRANCH LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37938-3200
Practice Address - Country:US
Practice Address - Phone:865-922-7765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-27
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3743152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist