Individual
WILLIAM J DEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
13872 128TH AVE, GRAND HAVEN, MI 49417-9775
(616) 856-1264
Mailing address
13872 128TH AVE, GRAND HAVEN, MI 49417-9775
(616) 856-1264
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
13267
WI
207P00000X
Emergency Medicine Physician
Primary
5101015965
MI
207P00000X
Emergency Medicine Physician
80964
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0154111485
BCBS
MI
01
—
1598712390
GROUP NPI
MI
01
—
381360529
TAX ID
MI
05
—
4878650
—
MI
05
—
4878678
—
MI
05
—
4878730
—
MI
05
—
4878749
—
MI
05
—
4878758
—
MI
Enumeration date
06/11/2006
Last updated
01/16/2026
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