MEDICARE: DR. JEFFREY ANOTHONY BONACCI DA, ATC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program	AT 267	AR

General Provider Information

NPI Number	:	1043368335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY ANOTHONY BONACCI DA, ATC

Provider Business Mailing Address
First Line	:	1696 N STARDUST LN
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72701-2883
Country	:	US
Telephone Number	:	479-575-4112
Fax Number	:	479-575-5778

Provider Business Practice Location Address
First Line	:	1696 N STARDUST LN
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72701-2883
Country	:	US
Telephone Number	:	479-575-4112
Fax Number	:	479-575-5778

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	07/08/2007

Similar Medicare Providers

1861808065 — DYNAMIC CONNECTIONS PLLC
Practice Location Address:

2612 THORNGROVE CT
FAYETTEVILLE, NC
28303-2883

Practice Phone: 910-364-7006
Practice Fax:

1992377386 — ROBERT ANTHONY LANE JR.
Practice Location Address:

2628 THORNGROVE CT
FAYETTEVILLE, NC
28303-2883

Practice Phone: 910-489-0531
Practice Fax:

1306655014 — ELKINS COMPLETE CARE
Practice Location Address:

2684 HOLLYBROOKE DR
FAYETTEVILLE, AR
72701-9298

Practice Phone: 501-463-0665
Practice Fax:

1922004787 — CARA R. HARTFIELD PHD
Practice Location Address:

112 W CENTER ST , SUITE 215
FAYETTEVILLE, AR
72701-6034

Practice Phone: 479-409-2212
Practice Fax: 479-439-8550

1871591057 — DR. LARRY C. WEEKS D.C.
Practice Location Address:

2618 W MLK JR. BLVD.
FAYETTEVILLE, AR
72701-7698

Practice Phone: 479-521-7755
Practice Fax: 479-521-6965

1699774208 — COLLIER DRUG STORES INC
Practice Location Address:

100 W DICKSON ST
FAYETTEVILLE, AR
72701-5219

Practice Phone: 479-442-6262
Practice Fax: 479-521-9111

Directions to “ DR. JEFFREY ANOTHONY BONACCI DA, ATC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.