=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477016723
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CRAIG J VERDIN DPM
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/12/2019
-----------------------------------------------------
Last Update Date | 02/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2116 W IOWA AVE
-----------------------------------------------------
City | CHICKASHA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73018-2736
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-224-2100
-----------------------------------------------------
Fax | 405-779-2801
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2220 W IOWA AVE
-----------------------------------------------------
City | CHICKASHA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73018-2738
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-779-2721
-----------------------------------------------------
Fax | 405-779-2310
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number | 401
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number | 692082
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------