Basic Information
| Provider Information | |||||||||
| NPI: | 1689832735 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WINN | ||||||||
| FirstName: | JAY | ||||||||
| MiddleName: | WESLEY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 827 E LAMAR ALEXANDER PKWY | ||||||||
| Address2: | |||||||||
| City: | MARYVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 378045001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8659840900 | ||||||||
| FaxNumber: | 8659841035 | ||||||||
| Practice Location | |||||||||
| Address1: | 827 E LAMAR ALEXANDER PKWY | ||||||||
| Address2: | |||||||||
| City: | MARYVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 378045001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8659840900 | ||||||||
| FaxNumber: | 8659841035 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2008 | ||||||||
| LastUpdateDate: | 06/29/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 43545 | TN | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 056790 | GA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 0268267 | 01 | CIGNA | OTHER | 4190044 | 01 | TN | BLUECROSS BLUESHIELD | OTHER | 3711721 | 01 | TN | MEDICARE PTAN | OTHER | 9050114 | 01 | AETNA | OTHER | 1506288 | 05 | TN | MEDICAID |