Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bola Gabriel

Individual provider Physician Assistant · NPI 1376079731

Bola Gabriel is a Physician Assistant in Antioch, Tennessee. Qualified in 2017, 9 years ago. Practices with Mid Tn Clinic PLLC, a 2-clinician group and accepts Medicare assignment.

Years since qualifying
9
In the registry since
2017

Practice location Address checks out

5100 Brookstone Ct
Antioch, TN 37013-5687
Phone: (615) 569-4067
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1376079731
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 4, 2017
Last updated in NPPESMay 4, 2017
Mailing address5100 Brookstone Ct, Antioch, TN 37013-5687

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Mid Tn Clinic Pllc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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