Healthcare Provider Details

I. General information

NPI: 1881663201
Provider Name (Legal Business Name): DAVID B CLUFF D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 08/07/2023
Certification Date: 08/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7920 W GIBSON RANCH RD
PAYSON AZ
85541-3496
US

IV. Provider business mailing address

7920 W GIBSON RANCH RD
PAYSON AZ
85541-3496
US

V. Phone/Fax

Practice location:
  • Phone: 928-951-0109
  • Fax:
Mailing address:
  • Phone: 928-951-0109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2924
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: