JACK WINFRED WYLIE MD
NPI 1043255052
Orthopaedic Surgery in Cottonwood, AZ

Active since June 17, 2006
450 S WILLARD ST, SUITE 105, COTTONWOOD, AZ 86326(928) 634-1112(928) 634-1117 Get Directions Write a Review

NPPES record last updated: March 16, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 16, 2017, Jun 24, 2016 (2 updates tracked since 2016).

About Jack Winfred Wylie Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK WINFRED WYLIE MD (NPI 1043255052) is an individual orthopaedic surgery provider in Cottonwood, Arizona, licensed in Arizona (23100) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1043255052
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameJACK WINFRED WYLIECredential: MD
Location Address450 S WILLARD ST, SUITE 105Cottonwood, AZ 86326-6743
Mailing Address1200 N Beaver St, Payer CredentialingFlagstaff, AZ 86001-3118 · (928) 773-2559 · Fax (928) 213-6292
Fax(928) 634-1117
Sole ProprietorNo
Enumeration DateJune 17, 2006
Last NPPES UpdateMarch 16, 20172 updates tracked since enumeration
NPI 1043255052 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License Licensed in AZ · 23100
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
450 S WILLARD ST, Cottonwood, AZ 86326

Other Identifiers 3

Medicare PINZ190852AZ
Medicare UPINF61342
Medicaid212134AZ

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
450 S WILLARD ST, SUITE 115
COTTONWOOD, AZ 86326
Physician Assistant
450 S WILLARD ST, STE. 120
COTTONWOOD, AZ 86326
Physician Assistant
450 S WILLARD ST
COTTONWOOD, AZ 86326
Physical Therapist
450 S WILLARD ST, STE 106
COTTONWOOD, AZ 86326
Psychiatry & Neurology (Neurology)
450 S WILLARD ST
COTTONWOOD, AZ 86326
Clinic/Center (Urgent Care)
450 S WILLARD ST, SUITE 120
COTTONWOOD, AZ 86326
Clinic/Center (Ambulatory Surgical)
450 S WILLARD ST, STE 105
COTTONWOOD, AZ 86326
Internal Medicine
450 S WILLARD ST, STE 103
COTTONWOOD, AZ 86326

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Wylie's NPI number?

The NPI number for Jack Wylie is 1043255052. It was assigned to this individual provider in the NPPES registry on June 17, 2006.

Where is Jack Wylie located?

Jack Wylie practices at 450 S Willard St Suite 105, Cottonwood, AZ 86326. The listed phone number is (928) 634-1112.

What is Jack Wylie's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

When was this NPI record last updated?

The NPPES record for Jack Wylie was last updated on March 16, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.