Individual
BRIAN BASCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-0211
Mailing address
3566 PEBBLE BEACH DR, MARTINEZ, GA 30907-9520
(404) 783-1582
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
10816
GA
Other
Enumeration date
04/15/2019
Last updated
04/15/2019
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