Kenneth J O'neill, MD | |
5515 Cleveland Ave, Stevensville, MI 49127-9670 | |
(269) 429-9644 | |
(269) 429-4002 |
Full Name | Kenneth J O'neill |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Location | 5515 Cleveland Ave, Stevensville, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1447266341 | NPI | - | NPPES |
110089876 | Other | MI | RAILROAD MEDICARE |
1101107081 | Other | MI | BLUE CROSS PIN |
2893924 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 4301045698 (Michigan) | Primary |
Entity Name | Lakeland Medical Practices |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1538397120 PECOS PAC ID: 1658427042 Enrollment ID: O20090928000216 |
Mailing Address | Practice Location Address |
---|---|
Kenneth J O'neill, MD 5515 Cleveland Ave, Stevensville, MI 49127-9670 Ph: (269) 429-9644 | Kenneth J O'neill, MD 5515 Cleveland Ave, Stevensville, MI 49127-9670 Ph: (269) 429-9644 |
Dr. Jill S Wang, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 5515 Cleveland Ave, Stevensville, MI 49127 Phone: 269-429-9644 Fax: 269-429-4002 | |
Brian Facione, D.O. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 5515 Cleveland Ave, Suite 5, Stevensville, MI 49127 Phone: 269-429-9644 Fax: 269-429-4002 |