# CRAIG KENYON UDALL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1396180477
- **Gender:** Man
- **Credential:** DPM

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213E00000X | Podiatrist | 0859 | AZ | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 0859 | AZ | Yes |

## Other

- **Enumeration date:** 05/02/2013
- **Last updated:** 06/04/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 270291 | — | AZ |
| 01 | — | 8154560001 | MEDICARE DME | — |
| 01 | — | Z274188 | MEDICARE PTAN | AZ |