Provider Demographics
NPI:1922536085
Name:CLUFF, WILLIAM REID (OD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:REID
Last Name:CLUFF
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 S. NOVELL PL
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84606-6171
Mailing Address - Country:US
Mailing Address - Phone:385-248-5534
Mailing Address - Fax:
Practice Address - Street 1:122 E 1700 S BLDG 3
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84606-5644
Practice Address - Country:US
Practice Address - Phone:385-248-5550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV966152W00000X
ALT-229-TA-A71152W00000X
UT13786729-9934152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152W00000XEye and Vision Services ProvidersOptometrist