Edwin Mackenzie Wyman, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

31702 Issued in CO

Practice address

1280 N Mildred Rd
Ste 1
Cortez, CO 81321-2212

Phone

(970) 565-9500

Fax

(970) 565-9538

NPI assigned

Aug 17, 2005

Last updated

Oct 4, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Mac Wyman Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191456000000",
    "number": "1730171620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1280 N MILDRED RD",
            "address_2": "STE 1",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813212212",
            "telephone_number": "970-565-9500",
            "fax_number": "970-565-9538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 N MILDRED RD",
            "address_2": "STE 1",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813212212",
            "telephone_number": "970-565-9500",
            "fax_number": "970-565-9538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYMAN",
        "first_name": "EDWIN",
        "middle_name": "MACKENZIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2007-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CO",
            "license": "31702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAC",
            "last_name": "WYMAN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Patricia Lynne Wilson
• Brooke Marie Windhorst, RDH
• Candiss Nicole Wolle, SWC
• Lauri E. Wood, R.N.
• Colette Wyatt
• Sharon Wynn, CDA, RDH
• Peggy E Youngs, P.T.
• Angela Yusuf, PHARMACIST
• Zina Ortiz (Elephant in the Room LLC)

• Orthopaedic Surgery Physician in Cortez, CO
• Providers in Cortez, CO by specialty
• Orthopaedic Surgery Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.