Provider Demographics
NPI:1801960430
Name:KLAUDER, MICHAEL J (PA)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:J
Last Name:KLAUDER
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Gender:M
Credentials:PA
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Mailing Address - Street 1:655 N ALVERNON WAY
Mailing Address - Street 2:216
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-1823
Mailing Address - Country:US
Mailing Address - Phone:520-327-0460
Mailing Address - Fax:520-795-0225
Practice Address - Street 1:9302 E 22ND ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-7342
Practice Address - Country:US
Practice Address - Phone:520-298-0147
Practice Address - Fax:520-298-7404
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
AZ1975363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant