MEDICARE: DR. DOUGLAS A. KLOSS AU.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	152-156	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588875843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS A. KLOSS AU.D.

Provider Business Mailing Address
First Line	:	4818 S 76TH ST
Second Line	:	SUITE 3
City	:	GREENFIELD
State	:	WI
Zip	:	53220-4362
Country	:	US
Telephone Number	:	414-281-8300
Fax Number	:

Provider Business Practice Location Address
First Line	:	4818 S 76TH ST
Second Line	:	SUITE 3
City	:	GREENFIELD
State	:	WI
Zip	:	53220-4362
Country	:	US
Telephone Number	:	414-281-8300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	11/18/2025

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