Provider Demographics
NPI:1962963876
Name:BADELL, BETHANY JOELLE (DPM)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:JOELLE
Last Name:BADELL
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 843022
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3022
Mailing Address - Country:US
Mailing Address - Phone:317-770-6900
Mailing Address - Fax:317-770-6911
Practice Address - Street 1:325 WESTFIELD RD STE B
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-1496
Practice Address - Country:US
Practice Address - Phone:317-770-7660
Practice Address - Fax:317-770-7661
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-26
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07001476A213E00000X
FLPO4372213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300098267Medicaid