Udall, Craig Kenyon

Udall, Craig Kenyon is an individual health care provider with primary practice located at 14539 W Indian School Rd Ste 880 , Goodyear AZ 85395-9279. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Udall, Craig Kenyon can be contacted via phone (623) 248-4734.

Contact Information

Primary practice address
14539 W Indian School Rd Ste 880 Goodyear AZ 85395-9279
Phone: (623) 248-4734
Fax: (623) 259-7006
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 0859 Arizona
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 0859 Arizona

Profile Details

NPI number 1396180477
LBN Legal business name Udall, Craig Kenyon
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date May 2nd, 2013
Last updated Jun 4th, 2024 - about 6 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396180477 NPPES
Other 8154560001 MEDICARE DME
Other Z274188 MEDICARE DME
MEDICAID 270291 MEDICARE DME

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