Healthcare Provider Details

I. General information

NPI: 1124905955
Provider Name (Legal Business Name): BETHANY KAY MCDONALD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2025
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S PARK ST
MADISON WI
53715-1893
US

IV. Provider business mailing address

10298 HIGH RIDGE RD
DARLINGTON WI
53530-9423
US

V. Phone/Fax

Practice location:
  • Phone: 608-259-5102
  • Fax: 608-259-3468
Mailing address:
  • Phone: 608-482-4392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number8481-23
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: