Healthcare Provider Details

I. General information

NPI: 1184540718
Provider Name (Legal Business Name): SYDNEY BUNKLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 FOX MEADOW DR
COVINGTON GA
30016-4359
US

IV. Provider business mailing address

300 FOX MEADOW DR
COVINGTON GA
30016-4359
US

V. Phone/Fax

Practice location:
  • Phone: 404-862-5011
  • Fax:
Mailing address:
  • Phone: 404-862-5011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: