John David Fagan, MD in Vicksburg, MS

John David Fagan, MD is a medicare enrolled "Urology" physician in Vicksburg, Mississippi. He went to University Of Texas Medical Branch At Galveston and graduated in 1984 and has 40 years of diverse experience with area of expertise as Urology. He is a member of the group practice Vicksburg Clinic Llc and 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.

Contact Information

	John David Fagan, MD
	2200 Highway 61 N, Vicksburg, MS 39183-8246
	(601) 883-5940
	Not Available

Map and Direction

Physician's Profile

Full Name	John David Fagan
Gender	Male
Speciality	Urology
Experience	40 Years
Location	2200 Highway 61 N, Vicksburg, Mississippi
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 University Of Texas Medical Branch At Galveston in 1984

NPI Data:

NPI Number: 1801827019
Provider Enumeration Date: 07/05/2006
Last Update Date: 09/10/2020

Medicare PECOS Information:

PECOS PAC ID: 7012067010
Enrollment ID: I20090612000518

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

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Merit Health River Region	Vicksburg, MS	Hospital
University Of Mississippi Med Center	Jackson, MS	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Vicksburg Clinic Llc	5890696330	23

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. John David Fagan allows following entities to bill medicare on his behalf.

Entity Name	Vicksburg Clinic Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1790711158 PECOS PAC ID: 5890696330 Enrollment ID: O20040116000738

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

John David Fagan, MD - Medicare Urology in Vicksburg, MS