Provider Demographics
NPI:1982678223
Name:DEEGAN, WILLIAM F III (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:F
Last Name:DEEGAN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:46161 WESTLAKE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-5871
Mailing Address - Country:US
Mailing Address - Phone:571-434-2927
Mailing Address - Fax:571-434-0838
Practice Address - Street 1:1420 BEVERLY RD STE 110
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3700
Practice Address - Country:US
Practice Address - Phone:571-378-2236
Practice Address - Fax:571-378-2237
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2021-04-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0047789207W00000X, 207WX0107X
DCMD21418207W00000X, 207WX0107X
VA0101052712207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC024863200Medicaid
MD355101600Medicaid
VA006306756Medicaid
VA006302980Medicaid
VA006306853Medicaid
MD355101501Medicaid
DC024863200Medicaid
F39846Medicare UPIN