IndividualActive
John Fagan, M.D.
NPI 1801827019 · Urology Physician · Vicksburg, MS
Provider details
- NPI number
- 1801827019
- Entity type
- Individual
- Primary specialty
- Urology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 12624 (MS)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
2200 Highway 61 N
Vicksburg, MS 39183-8246
Phone: (601) 883-5940
Approximate (ZIP-level) locationGet directions
Mailing address
2080 South Frontage Rd
Vicksburg, MS 39180
Registry dates
- Enumerated
- 2006-07-05
- Last updated
- 2020-09-10
- Certified
- 2020-09-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.