OrganizationActive
Mark D. Wigod, MD, PA
NPI 1679751770 · Plastic and Reconstructive Surgery Physician · Meridian, ID
Provider details
- NPI number
- 1679751770
- Entity type
- Organization
- Primary specialty
- Plastic and Reconstructive Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mark Wigod, President(208) 377-9515
- License
- M8189 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3630 E Louise Dr
Meridian, ID 83642-7975
Phone: (208) 377-9515
Street-level locationGet directions
Mailing address
3630 E Louise Dr
Meridian, ID 83642-7975
Registry dates
- Enumerated
- 2008-01-31
- Last updated
- 2008-01-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.