MEDICARE: ROBERT G. WEATHERSTONE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	026814	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	202I105894	OTHER	GA	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437150455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT G. WEATHERSTONE MD

Provider Business Mailing Address
First Line	:	2300 MANCHESTER EXPY STE 2001A
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-6802
Country	:	US
Telephone Number	:	706-320-3126
Fax Number	:	706-320-3054

Provider Business Practice Location Address
First Line	:	2300 MANCHESTER EXPY
Second Line	:	STE A201
City	:	COLUMBUS
State	:	GA
Zip	:	31904-6802
Country	:	US
Telephone Number	:	706-320-2766
Fax Number	:	706-320-2768

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	08/07/2024

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Directions to “ ROBERT G. WEATHERSTONE MD” Practice Location

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