Stacey Basquin PAC

NPI 1760549919 - Physician Assistant - 363A00000X

NPI Details
NPI 1760549919
Gender Female
Enumeration Date 01/03/2007
Last Updated 09/25/2013
Entity Type Individual
Active Over 9 years ago
Practice Location
1601 FAIR ROAD
SUITE 600 COTTON RIDGE MEDICAL PLAZA
STATESBORO GA, 30458, US
Phone (912) 681-4911
Fax (912) 681-6911
Business Location
PO BOX 1640
STATESBORO GA, 30459-1640, US
Phone (912) 681-4911
Fax (912) 681-6911
Toxanomy
Taxonomy Code 363A00000X
License State Georgia
License Number 4104GA
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According to our database, Stacey Basquin PAC NPI is 1760549919, taxonomy code is 363A00000X and license number is 4104GA, license state is located at Georgia. Stacey Basquin PAC physically located at 1601 Fair Road, Statesboro GA, 30458. NPI Number Stacey Basquin PAC has the Individual type.

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1760549919 NPI number is provided on an as is basis without warranty of any kind. 1760549919 is maintained by the National Plan & Provider Enumeration System. The contents of Stacey Basquin PAC are for informational purposes only.