CRAIG KENYON UDALL (NPI# 1396180477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396180477 |
| Entity Type | Individual |
| Full Name | CRAIG KENYON UDALL |
| Credential | DPM |
| Practice Address |
7330 N 99th Ave # 325 Glendale AZ 85307-3003 |
| Mailing Address |
3815 E Bell Rd Ste 2200 Phoenix AZ 85032-2139 |
| Practice Telephone | 6238821292 |
| Mailing Telephone | 6026333838 |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2019-04-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213E00000X | Podiatrist | 0859 | AZ | Podiatric Medicine & Surgery Service Providers |
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
0859 | AZ | Podiatric Medicine & Surgery Service Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | MEDICARE | Z202877 | 01 |
| AZ | 270291 | 05 |
| Street Address |
7330 N 99TH AVE # 325 |
| City | GLENDALE |
| State | AZ |
| Zip Code | 85307-3003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346586013 | Integrated Medical Services Inc | Orthopaedic Surgery | 7330 N 99th Ave # 325, Glendale, AZ 85307-3003 | 2012-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154635761 | Aeroptics LLC | Optometrist | 7071 N 138th Av, Bldg 1540, Glendale, AZ 85307 | 2010-08-06 |
| 1902894579 | Daniela Nicosia | Optometrist | 7071 N 138th Ave, Luke Afb, AZ 85307 | 2005-10-07 |
| 1144633157 | Sharan Kaur Knott | Pharmacist | 10945 W Vista Ln, Glendale, AZ 85307-1645 | 2014-06-06 |
| 1841813961 | Yoshica Mitchell | Behavior Technician | 12923 W Lawrence Ct, Glendale, AZ 85307-1900 | 2020-05-22 |
| 1700328556 | Tonya Brown | Social Worker | 12912 W Mclellan Rd, Glendale, AZ 85307-1917 | 2016-11-10 |
| 1447806997 | Tamarra Kalamchi | Dentist | 7071 N 138th Ave Bldg 1540, Glendale, AZ 85307-2006 | 2019-08-12 |
| 1043623648 | Dr Larsen Eye Care Inc | Optometrist | 7071 N 138th Ave # 1552, Luke Afb, AZ 85307-2006 | 2014-06-11 |
| 1619519840 | Platinum Venture Group LLC | Durable Medical Equipment & Medical Supplies | 7071 N 138th Ave Bldg 1540, Glendale, AZ 85307-2006 | 2019-10-09 |
| 1710255989 | Optical Center | Technician/Technologist | 7071 N 138th Ave, Glendale, AZ 85307-2006 | 2011-12-02 |
| 1386088128 | Clifton Jamar Premo | Respiratory Therapist, Registered | 13517 W Glendale Ave, Apt 1135, Glendale, AZ 85307-2010 | 2013-04-23 |
| Find all providers in zip 85307 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467072090 | Foot & Ankle Specialists of Arizona | Podiatrist | 5681 W Beverly Ln Ste 100a, Glendale, AZ 85306-9800 | 2020-04-23 |
| 1609366533 | Podiatric Physicians of Arizona, Inc. | Podiatrist | 11851 N 51st Ave Ste D120, Glendale, AZ 85304-2839 | 2018-05-16 |
| 1790218550 | Noubar Varderessian | Podiatrist | 1122 N Columbus Ave, Apt. 2, Glendale, CA 91202-3241 | 2017-04-09 |
| 1659721850 | Samvel Keshishyan | Podiatrist | 1339 N Columbus Ave Unit 311, Glendale, CA 91202-3875 | 2016-06-17 |
| 1639583388 | Jamila Butcher | Podiatrist | 5605 W Eugie Ave Ste 102, Glendale, AZ 85304-1273 | 2014-06-19 |
| 1710302450 | New Age Foot and Ankle Podiatry PC | Podiatrist | 705 Ivy Street, Glendale, CA 91204 | 2014-03-04 |
| 1710173489 | Glendale Foot & Ankle Podiatry Center, Inc. | Podiatrist | 1030 S Glendale Ave Ste 403, Glendale, CA 91205-2866 | 2007-09-17 |
| 1760564272 | Hermoz B Ayvazian | Podiatrist | 110 S Adams St, Glendale, CA 91205-1312 | 2006-10-20 |
| 1467567883 | Rajesh Praful Daulat | Podiatrist | 6677 W Thunderbird Rd Ste J171-172, Glendale, AZ 85306-3732 | 2006-08-19 |
| 1780606764 | Allen Massihi | Podiatrist | 311 N Verdugo Rd, Glendale, CA 91206-3944 | 2006-07-25 |
| Find all providers in GLENDALE | ||||
Please comment or provide details below to improve the information on CRAIG KENYON UDALL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.