Provider Demographics
NPI:1255531778
Name:DENISON, ABEGAILE SANTIAGO (MD)
Entity type:Individual
Prefix:DR
First Name:ABEGAILE
Middle Name:SANTIAGO
Last Name:DENISON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ABEGAILE
Other - Middle Name:MARTINEZ
Other - Last Name:SANTIAGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:647 DUNLOP LN STE 301
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-5265
Mailing Address - Country:US
Mailing Address - Phone:270-461-4677
Mailing Address - Fax:931-645-4104
Practice Address - Street 1:647 DUNLOP LN STE 301
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-5265
Practice Address - Country:US
Practice Address - Phone:270-461-4677
Practice Address - Fax:931-645-4104
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN48358207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine