Provider Demographics
NPI:1023011442
Name:GABRIEL, THOMAS MATTHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MATTHEW
Last Name:GABRIEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 DUTCHMANS PKWY
Mailing Address - Street 2:STE 215
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-3343
Mailing Address - Country:US
Mailing Address - Phone:502-721-8288
Mailing Address - Fax:502-721-8792
Practice Address - Street 1:6400 DUTCHMANS PKWY
Practice Address - Street 2:STE 215
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-3343
Practice Address - Country:US
Practice Address - Phone:502-721-8288
Practice Address - Fax:502-721-8792
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY32683207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY200040465OtherRAILROAD MEDICARE
KY000000192074OtherBLUE PREFERRED (ANTHEM)
KY64326838Medicaid
E11169Medicare UPIN
KY000000192074OtherBLUE PREFERRED (ANTHEM)