Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Michael Klose

Individual provider Physician Assistant · NPI 1053717975

Michael Klose is a Physician Assistant in Tinker AFB, Oklahoma. Qualified in 2015, 11 years ago. Accepts Medicare assignment.

Years since qualifying
11
In the registry since
2014
Specialties on file
2
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Practice location Address checks out

7050 Air Depot Blvd
Tinker AFB, OK 73145-8716
Phone: (405) 734-2778
Fax: (405) 736-3128
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1053717975
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 5, 2014
Last updated in NPPESOctober 7, 2024
Certification dateOctober 7, 2024
Mailing address7050 Air Depot Blvd, Tinker Afb, OK 73145-8716

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Tinker AFB