Individual
DR. JOHN W HUDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1930 ALCOA HWY, STE 335, KNOXVILLE, TN 37920-1500
(865) 544-9021
(865) 544-9565
Mailing address
1930 ALCOA HWY, STE 335, KNOXVILLE, TN 37920-1500
(865) 544-9021
(865) 544-9565
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS006030
TN
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
2901014026
MI
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
DS006030
TN
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
CERTIFICATE
CA
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
CERTIFICATE
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005113
ASSURANT EMPLOYEE BENEFIT
IA
01
—
0015837
BLUE CROSS BLUE SHIELD
—
01
—
1211270
CIGNA DENTAL DMO OFFC 1
TN
01
—
199845
CIGNA DENTAL DMO OFFC 2
TN
01
—
199846
CIGNA DENTAL DMO OFFC 3
TN
05
—
3224723
—
TN
01
—
621199959
CIGNA DENTAL PPO
TN
01
—
64777451
KENTUCKY MEDICAID
KY
01
—
732021
DENTAL BEN. PROV. OFFC 1
UT
01
—
732022
DENTAL BEN. PROV. OFFC 2
UT
01
—
732023
DENTAL BEN. PROV. OFFC 3
UT
01
—
DS006030
LICENSE
TN
01
—
TN0102
AMERICHOICE TENNCARE O-1
TN
01
—
TN0103
AMERICHOICE TENNCARE O-2
TN
01
—
TN0104
AMERICHOICE TENNCARE O-3
TN
Enumeration date
07/24/2006
Last updated
04/17/2008
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