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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
M8189 | ID | Allopathic & Osteopathic Physicians |
Street Address |
3630 E LOUISE DRIVE |
City | MERIDIAN |
State | ID |
Zip Code | 83642 |
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 Code | 2086S0122X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Plastic and Reconstructive Surgery |
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. |
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 |
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 |
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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.