MEDICARE: REINALDO D VERSON 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	2084N0400X	Neurology Physician	038120	GA
2	2084N0400X	Neurology Physician	38120	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	130017941	OTHER	GA	RAIL ROAD MEDICARE

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063435428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REINALDO D VERSON MD

Provider Business Mailing Address
First Line	:	PO BOX 9247
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31908-9247
Country	:	US
Telephone Number	:	706-322-7884
Fax Number	:	706-243-4356

Provider Business Practice Location Address
First Line	:	2300 MANCHESTER EXPY STE A201
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-6856
Country	:	US
Telephone Number	:	706-320-2766
Fax Number	:	706-320-2768

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	12/15/2025

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Directions to “ REINALDO D VERSON MD” Practice Location

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