Craig Kenyon Udall, DPM | |
14044 W Camelback Rd Ste 226, Litchfield Park, AZ 85340-9426 | |
(623) 248-4734 | |
(877) 311-9529 |
Full Name | Craig Kenyon Udall |
---|---|
Gender | Male |
Speciality | Podiatrist - Foot & Ankle Surgery |
Location | 14044 W Camelback Rd Ste 226, Litchfield Park, Arizona |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1396180477 | NPI | - | NPPES |
270291 | Medicaid | AZ | |
Z274188 | Other | AZ | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | 0859 (Arizona) | Secondary |
213ES0103X | Podiatrist - Foot & Ankle Surgery | 0859 (Arizona) | Primary |
Provider Name | Rwj Podiatry Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1386384790 PECOS PAC ID: 8729466677 Enrollment ID: O20220603002585 |
Mailing Address | Practice Location Address |
---|---|
Craig Kenyon Udall, DPM 14044 W Camelback Rd Ste 226, Litchfield Park, AZ 85340-9426 Ph: (623) 248-4734 | Craig Kenyon Udall, DPM 14044 W Camelback Rd Ste 226, Litchfield Park, AZ 85340-9426 Ph: (623) 248-4734 |
Foot Envy Podiatrist Medicare: Medicare Enrolled Practice Location: 14044 W Camelback Rd Ste 226, Litchfield Park, AZ 85340 Phone: 623-248-4734 Fax: 877-311-9529 | |
Ralph B Rabin Dpm Llc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 14044 W Camelback Rd, Suite 114, Litchfield Park, AZ 85340 Phone: 623-846-9000 Fax: 623-846-4021 |