Provider Demographics
NPI:1295419661
Name:DUFF, WILLIAM C JR (ABOM, NCLEM,CLSAF)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:DUFF
Suffix:JR
Gender:M
Credentials:ABOM, NCLEM,CLSAF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 BURT RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2480
Mailing Address - Country:US
Mailing Address - Phone:859-278-6026
Mailing Address - Fax:859-278-6027
Practice Address - Street 1:124 BURT RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2480
Practice Address - Country:US
Practice Address - Phone:859-278-6026
Practice Address - Fax:859-278-6027
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
156FC0801X
KY111492156FC0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens Fitter