Individual
JAY A WINZENRIED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
721 SHERIDAN AVE STE 130, CODY, WY 82414-3436
(307) 527-7100
(307) 527-7145
Mailing address
721 SHERIDAN AVE STE 130, CODY, WY 82414-3436
(307) 527-7100
(307) 527-7145
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
6422A
WY
332B00000X
Durable Medical Equipment & Medical Supplies
4931310001
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0065059
—
MT
05
—
115812100
—
WY
01
—
115812101
MEDICAID DME
WY
01
—
312326
BLUE CROSS BLUE SHEILD
WY
01
—
486921300
FEDERAL WORK COMP
WY
01
—
4931310001
DMERC
WY
01
—
P00096957
RAILROAD MEDICARE
WY
Enumeration date
10/20/2005
Last updated
08/03/2010
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