Mac Wyman MD PC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

31702 Issued in CO

Legal business name

MAC WYMAN MD PC

Practice address

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

Phone

(970) 565-9500

Fax

(970) 565-9538

NPI assigned

Sep 24, 2007

Last updated

May 30, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kim A Archuleta

Title

Office Manager

Phone

(970) 565-9500

Specialties & licenses 1

Addresses

Other names 1

• Edwin M Wyman, MD, PC Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dee Prock, P.T.

  • Physical Therapist
  • Cortez, CO
  • NPI 1780680322
  NPD (past)

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559174400000",
    "number": "1790971679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1280 N MILDRED RD 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 STE 1",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813212212",
            "telephone_number": "970-565-9500",
            "fax_number": "970-565-9538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "380 West 100 North",
            "address_purpose": "LOCATION",
            "city": "Monticello",
            "state": "UT",
            "postal_code": "84535",
            "country_code": "US",
            "telephone_number": "435-587-2116",
            "fax_number": "435-587-3485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAC WYMAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2019-05-30",
        "status": "A",
        "authorized_official_last_name": "ARCHULETA",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "970-565-9500"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CO",
            "license": "31702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edwin M Wyman, MD, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Edwin M Wyman, MD, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Roberta Lock, RN
• Tywana Lopez, LCSWC
• Lovell Ortrhodontics, PC (Bright Day Orthodontics)
• Jeni Lyn Lovett, NP
• Kathy Sue Lynch, M.D.
• Madison Assisted Living LLC
• Michael Joseph Maloy, LPN, CACIII, NCACI
• Mark Maness
• Kelly L Marston, RN
• Mark Martinez

• 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 May 30, 2019; 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.