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General NPI Number Information
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NPI Number | 1922020379
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Entity Type | Individual
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Provider Name | JOHN W HUDSON DDS
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Gender | Male
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 04/17/2008
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Provider Practice Location Address
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Address Line | 1930 ALCOA HWY STE 335
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City | KNOXVILLE
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State | TN
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Zip | 37920-1500
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Country | US
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Telephone | 865-544-9021
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Fax | 865-544-9565
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Provider Business Mailing Address
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Address Line | 1930 ALCOA HWY STE 335
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City | KNOXVILLE
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State | TN
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Zip | 37920-1500
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Country | US
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Telephone | 865-544-9021
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Fax | 865-544-9565
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DS006030
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | DS006030
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 2901014026
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 207PE0005X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
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License Number | CERTIFICATE
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number | CERTIFICATE
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License Number State | CA
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