DR. MARK DAVID WIGOD


Address: 3630 E Louise Drive, Meridian, ID 83642
Phone: 2083779515

DR. MARK DAVID WIGOD (NPI# 1427086164) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1427086164
Entity Type Individual
Full Name DR. MARK DAVID WIGOD
Credential MD
Practice Address 3630 E Louise Drive
Meridian
ID 83642
Mailing Address 7157 N Spurwing Way
Meridian
ID 83642-5179
Practice Telephone 2083779515
Practice Fax Number 2083779517
Enumeration Date 2006-06-29
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2086S0122X Surgery
Specialization: Plastic and Reconstructive Surgery
M8189 ID Allopathic & Osteopathic Physicians

Office Location

Street Address 3630 E LOUISE DRIVE
City MERIDIAN
State ID
Zip Code 83642

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1174145684 Ikdo South Meridian LLC Dentist 3839 E Amity Rd, Meridian, ID 83642 2020-05-07
1073133328 Prescription Pad LLC Pharmacy 885 S Vanguard Way, Meridian, ID 83642 2020-04-16
1609412683 Meridian Advanced Psychiatry, LLC Psychiatry & Neurology 1672 S Woodsage Ave., Meridan, ID 83642 2019-11-25
1194378927 Sergey Tsema Occupational Therapist 1259 E Pisa St, Meridian, ID 83642 2019-07-21
1003478629 Chris R Jackson Dentist Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 2019-07-03
1285293118 Morgan Family Medicine Nurse Practitioner 1660 S Woodsage Avenue, Meridian, ID 83642 2019-06-13
1033772793 Nugen Healthcare, Pllc Registered Nurse 2177 S Spoonbill Ave, Meridian, ID 83642 2019-04-18
1811471790 Courtney Crossland Physician Assistant 4949 S Hillsdale Ave., Meridian, ID 83642 2018-09-18
1841771938 Katelyn Perry Counselor 2068 S. Eagle Rd., Meridian, ID 83642 2018-08-27
1114406204 Gem Prep: Meridian LLC Case Management 2750 E.gala Ct., Meridian, ID 83642 2018-08-09
Find all providers in zip 83642

Taxonomy Information

Taxonomy Code 2086S0122X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Plastic and Reconstructive Surgery

Taxonomy Definition

A surgeon who specializes in plastic and reconstructive surgery.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1588877641 John Arthur Jarrell Iv Surgery 3090 E Gentry Way Ste 210, Meridian, ID 83642-3550 2007-05-07
1477195931 Jarrell Plastic Surgery Surgery 3090 E Gentry Way Ste 210, Meridian, ID 83642-3550 2019-10-16
1275772667 Rebecca D Shaw Surgery 3630 E Louise Dr, Meridian, ID 83642-7975 2009-02-09
1679751770 Mark D. Wigod, Md, Pa Surgery 3630 E Louise Dr, Meridian, ID 83642-7975 2008-01-31

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1427523968 Q17 Health Partners LLC Surgery 100 East Idaho Street #317, Boise, ID 83712 2018-10-11
1265656268 David William Becker Jr. Surgery 668 Ballingrude Dr, Twin Falls, ID 83301-4403 2007-04-12
1912046210 Center for Aesthetics PC Surgery 2375 E Sunnyside Road, Suite G, Idaho Falls, ID 83404 2007-02-05
1073668042 Thomas Floyd Crais Jr. Surgery 315 S River St, Hailey, ID 83333-8426 2007-01-23
1003823956 Craig B. Bass Surgery 250 Bobwhite Ct, # 275, Boise, ID 83706-6643 2006-08-02
1629069885 Patrick James Mullen Surgery 2121 W Ironwood Center Dr, Coeur D Alene, ID 83814-2639 2005-11-04
1720381536 Patrick J Mullen Md Pllc Surgery 750 N Syringa St, Suite 204, Post Falls, ID 83854-5275 2010-12-16
1073757464 Michael R Dibenedetto Md Pllc Surgery 30544 Highway 200, Suite 102, Ponderay, ID 83852-5005 2009-04-29
1881881118 Steven E Ozeran, M.d., P.a. Surgery 1630 23rd Ave, Suite 901a, Lewiston, ID 83501-6350 2007-10-01
1154549616 Teton Plastic Surgery Surgery 2860 Channing Way, Suite 213, Idaho Falls, ID 83404-7531 2007-04-23
Find all providers with the same taxonomy

Competitor

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City MERIDIAN
Zip Code 83642

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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