# DR. JOHN A GHOLSON III

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1023029865
- **Gender:** Man
- **Credential:** DENTIST

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS 1492 | TN | Yes |

## Other

- **Enumeration date:** 08/10/2006
- **Last updated:** 08/12/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0543098 | UNITED CONCORDIA | TN |
| 01 | — | 2007322 | BCBS | TN |