Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 32683 | KY |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 32683 | KY |
NPI | 1023011442 |
---|---|
Provider Name | Dr. Thomas Matthew Gabriel |
First Address | Louisville, KY 40205-3343 |
Second Address | Louisville, KY 40205-3343 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 11/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000192074 | BLUE PREFERRED (ANTHEM) (01) | KY |
200040465 | RAILROAD MEDICARE (01) | KY |
64326838 | (05) | KY |
E11169 | (02) |