Provider Demographics
NPI:1114941226
Name:CLIFFORD, WILLIAM S (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:S
Last Name:CLIFFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-5560
Mailing Address - Country:US
Mailing Address - Phone:620-275-7248
Mailing Address - Fax:620-275-5262
Practice Address - Street 1:502 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5560
Practice Address - Country:US
Practice Address - Phone:620-275-7248
Practice Address - Fax:620-275-5262
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-25184208600000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO91251843Medicaid
OK100018320AMedicaid
KS100180100AMedicaid
KS180028457Medicare ID - Type UnspecifiedRR MEDICARE
OK100018320AMedicaid
CO91251843Medicaid