Individual
ANTONIO GOBENCIONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3780 EISENHOWER PKWY, MACON, GA 31206-0800
(478) 633-5550
(478) 784-3550
Mailing address
3780 EISENHOWER PKWY, MACON, GA 31206-0800
(478) 633-5550
(478) 784-3550
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
207Q00000X
Family Medicine Physician
Primary
009141
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2017
Last updated
12/22/2021
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