Individual
DR. MEXTON M DEACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1626 W FOND DU LAC AVE, STE 111, MILWAUKEE, WI 53205-1228
(414) 326-9034
(414) 763-2305
Mailing address
1626 W FOND DU LAC AVE, STE 111, MILWAUKEE, WI 53205-1228
(414) 326-9034
(414) 763-2305
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
949-25
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000751
—
WI
Enumeration date
10/10/2007
Last updated
12/01/2020
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