Provider Demographics
NPI:1881663201
Name:CLUFF, DAVID B (DO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:B
Last Name:CLUFF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7920 W GIBSON RANCH RD
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85541-3496
Mailing Address - Country:US
Mailing Address - Phone:928-951-0109
Mailing Address - Fax:
Practice Address - Street 1:7920 W GIBSON RANCH RD
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541-3496
Practice Address - Country:US
Practice Address - Phone:928-951-0109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2924207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ175605Medicaid
Z74006Medicare PIN
F82237Medicare UPIN