| 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 |