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MARK D. WIGOD, MD, PA
NPI 1679751770
Surgery - Plastic and Reconstructive Surgery in Meridian, ID

Active since January 31, 2008
3630 E LOUISE DR, MERIDIAN, ID 83642(208) 377-9515 Get Directions Write a Review

NPPES record last updated: January 31, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mark D. Wigod, Md, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK D. WIGOD, MD, PA (NPI 1679751770) is a healthcare organization registered as a plastic and reconstructive surgery in Meridian, Idaho and active in the NPI registry since January 2008. The organization lists Mark David Wigod, President, as its authorized official.

NPPES Registry Identity

NPI1679751770
Entity TypeOrganization
Primary Taxonomy2086S0122X
Legal Business NameMARK D. WIGOD, MD, PA
Location Address3630 E LOUISE DRMeridian, ID 83642-7975
Mailing Address3630 E Louise DrMeridian, ID 83642-7975 · (208) 377-9515
Phone(208) 377-9515
Organization SubpartNo
Authorized OfficialMark David WigodPresident · (208) 377-9515
Enumeration DateJanuary 31, 2008
✔ NPI 1679751770 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
License✔ Licensed in ID · M8189
Definition
A surgeon who specializes in plastic and reconstructive surgery.
3630 E LOUISE DR, Meridian, ID 83642
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Other Identifiers 2

Medicare PIN1374083ID
Medicare UPINH44448

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JT ANESTHESIA SERVICES PLLP
Nurse Anesthetist, Certified Registered
3630 E LOUISE DR
MERIDIAN, ID 83642
Ada County (208) 377-9515
REBECCA D SHAW CFA
Surgery (Plastic and Reconstructive Surgery)
3630 E LOUISE DR
MERIDIAN, ID 83642
Ada County (208) 377-9515
CHAMAGNE JANAE EATON CST
3630 E LOUISE DR
MERIDIAN, ID 83642
Ada County (208) 377-9515
EP SERVICES LLC
Nurse Anesthetist, Certified Registered
3630 E LOUISE DR
MERIDIAN, ID 83642
Ada County (208) 377-9515
MEADOW LAKE SURGERY CENTER INC
Clinic/Center (Ambulatory Surgical)
3630 E LOUISE DR, SUITE 200
MERIDIAN, ID 83642
Ada County (208) 377-9515
JACQUELINE KING
Clinic/Center (Ambulatory Surgical)
3630 E LOUISE DR
MERIDIAN, ID 83642
Ada County (208) 377-9515

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark D. Wigod, MD, PA's NPI number?

The NPI number for Mark D. Wigod, MD, PA is 1679751770. It was assigned to this organization in the NPPES registry on January 31, 2008.

Where is Mark D. Wigod, MD, PA located?

Mark D. Wigod, MD, PA is located at 3630 E Louise Dr, Meridian, ID 83642. The listed phone number is (208) 377-9515.

What is Mark D. Wigod, MD, PA's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

When was this NPI record last updated?

The NPPES record for Mark D. Wigod, MD, PA was last updated on January 31, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.