John David Fagan, MD is a medicare enrolled "Urology" physician in Vicksburg, Mississippi. His current practice location is
2200 Highway 61 N, Vicksburg, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(601) 883-5940.
John David Fagan is licensed to practice in Mississippi (license number 12624) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1801827019.
Physician's Profile
Full Name | John David Fagan |
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Gender | Male |
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Speciality | |
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Experience | Years |
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Location | 2200 Highway 61 N, Vicksburg, Mississippi |
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Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- John David Fagan attended and graduated from in
NPI Data:
- NPI Number: 1801827019
- Provider Enumeration Date: 07/05/2006
- Last Update Date: 09/10/2020
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for John David Fagan such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1801827019 | NPI | - | NPPES |
00016970 | Medicaid | MS | |
4547365 | Other | MS | AETNA |
1901474 | Medicaid | LA | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208800000X | Urology | 12624 (Mississippi) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. John David Fagan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
John David Fagan, MD 2080 South Frontage Rd, Suite 100, Vicksburg, MS 39180 Ph: (601) 262-1000 | John David Fagan, MD 2200 Highway 61 N, Vicksburg, MS 39183-8246 Ph: (601) 883-5940 |
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