Provider Demographics
NPI:1730163817
Name:DEATON, JEFFREY LYNN (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:LYNN
Last Name:DEATON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:131 MILLER ST
Mailing Address - Street 2:SUITE 207 C
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-2508
Mailing Address - Country:US
Mailing Address - Phone:336-883-2500
Mailing Address - Fax:336-883-9728
Practice Address - Street 1:131 MILLER ST
Practice Address - Street 2:SUITE 207 C
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-2508
Practice Address - Country:US
Practice Address - Phone:336-883-2500
Practice Address - Fax:336-883-9728
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2016-09-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC38926207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
3300291OtherUNITED HEALTHCARE
189420OtherMEDCOST
28024OtherBCBS
3300291OtherUNITED HEALTHCARE