Deacon, Mexton M

Deacon, Mexton M is an sole proprietor health care provider with primary practice located at 1626 W Fond Du Lac Ave Ste 111, Milwaukee WI 53205-1228. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Deacon, Mexton M can be contacted via phone (414) 326-9034.

Contact Information

Primary practice address
1626 W Fond Du Lac Ave Ste 111 Milwaukee WI 53205-1228
Phone: (414) 326-9034
Fax: (414) 763-2305
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 949-25 Wisconsin

Profile Details

NPI number 1811185283
LBN Legal business name Deacon, Mexton M
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 10th, 2007
Last updated Dec 1st, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811185283 NPPES
Wisconsin MEDICAID 100000751

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