Individual
STACEY BASQUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1601 FAIR RD STE 600, STATESBORO, GA 30458-0800
(912) 681-4911
(912) 681-6911
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7211
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4104GA
GA
Other
Enumeration date
01/03/2007
Last updated
02/09/2026
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