Doctor profile · Federal record
Dr. Jack Wylie, MD
Orthopaedic Surgery Physician · Cottonwood, AZ
- NPI 1043255052
- 20 yrs on file
- Male
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
450 S Willard St, Suite 105
Cottonwood, AZ 863266743
(928) 634-1112
fax (928) 634-1117 - Mailing address
-
1200 N Beaver St, Payer Credentialing
Flagstaff, AZ 860013118
Credentials & registration
- NPI registered
- June 2006 — 20 yrs on file
- Profile last updated
- March 16, 2017
- Specialty taxonomy
- 207X00000X — NUCC code
- State license (1)
- Arizona #23100
- Medicaid
- AZ #212134
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1043255052. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$19
Transactions
1
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Boston Scientific Corporation | 1 | $18.97 |
By nature of payment
Frequently asked questions
What is Dr. Jack Wylie's medical specialty?
Dr. Jack Wylie practices Orthopaedic Surgery Physician in Cottonwood, AZ.
Where does Dr. Jack Wylie practice?
Dr. Jack Wylie practices at 450 S Willard St, Cottonwood, AZ 863266743. Office phone: 9286341112.
What is Dr. Jack Wylie's NPI?
Dr. Jack Wylie's National Provider Identifier (NPI) is 1043255052, issued by NPPES.