Individual
DR. JAMES THEODOR BONUCCHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
960 E WALNUT LAWN, SUITE 201, SPRINGFIELD, MO 65807
(417) 269-4450
(417) 269-4470
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-5712
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
3718
IA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
2008009810
MO
Other
Enumeration date
07/14/2006
Last updated
06/04/2019
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