MEDICARE: DR. BETHANY B BURKHART-EDELEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	40034	KY
2	207P00000X	Emergency Medicine Physician	35.085187	OH
3	207P00000X	Emergency Medicine Physician	01069980A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01069980A	OTHER	IN	STATE MEDICAL LICENSE

General Provider Information

NPI Number	:	1386650927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BETHANY B BURKHART-EDELEN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 776351
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-6351
Country	:	US
Telephone Number	:	502-588-9490
Fax Number	:	502-272-5116

Provider Business Practice Location Address
First Line	:	1305 N ELM ST
Second Line	:
City	:	HENDERSON
State	:	KY
Zip	:	42420
Country	:	US
Telephone Number	:	270-827-7700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	04/08/2026

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Directions to “ DR. BETHANY B BURKHART-EDELEN M.D.” Practice Location

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