Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. STEPHEN JOSEPH BONANNI JR., PA
Deactivated Sole ProprietorMR. STEPHEN JOSEPH BONANNI JR., PA is a Physician Assistant healthcare provider located in HINESVILLE, Georgia. NPI 1760812895 is deactivated in the NPPES registry. Verify at CMS.
Physician Assistant · HINESVILLE, GA
This NPI has been deactivated.
The record was deactivated on March 25, 2025.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1760812895
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 27, 2013 (11.323287671233 yrs)
- Last Updated
- Sep 16, 2025
- Deactivated
- Mar 25, 2025
- License
-
12279 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
508 N MAIN ST STE AHINESVILLE, GA, 313132570Browse GA providers · Browse ZIP 31313
- Phone
- 9127852100
- Fax
- 9123683868
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Physician Assistant
Other Physician Assistant Providers in HINESVILLE, GA
| Name | Credential | NPI |
|---|---|---|
| MRS. REBECCA LYNN GREGG | PA-C | 1619958238 |
| ROCKSAN MOSS | PA | 1225098510 |
| MR. RICHARD EUGENE GIECK | PA-C | 1023282183 |
| LARRY IVAN CANFIELD | PA | 1558538355 |
| CHRISTI G GIBSON | PA | 1093971103 |
| DAWN CELESTE HOWELL | DAWN HOWELL | 1689994360 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.