Individual
DR. JEFFERY S DEACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3403 PROFESSIONAL PARK DR, MARION, IL 62959-6394
(618) 993-0333
(618) 993-0545
Mailing address
3403 PROFESSIONAL PARK DR, MARION, IL 62959-6394
(618) 993-0333
(618) 993-0545
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004769
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016004769001
—
IL
Enumeration date
10/02/2006
Last updated
04/16/2008
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