Fagan, Bryan Christopher

Fagan, Bryan Christopher is an individual health care provider with primary practice located at 499 Gloster Creek Vlg Ste G1, Tupelo MS 38801-4751. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Orthopaedic Trauma. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Fagan, Bryan Christopher can be contacted via phone (662) 377-2663.

Contact Information

Primary practice address
499 Gloster Creek Vlg Ste G1 Tupelo MS 38801-4751
Fax: (662) 377-6706
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X AU5009697-756 Mississippi
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 20606 Mississippi
Allopathic & Osteopathic Physicians / Orthopaedic Trauma 207XX0801X 20606 Mississippi
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 20606 Mississippi

Profile Details

NPI number 1669683405
LBN Legal business name Fagan, Bryan Christopher
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2007
Last updated Jan 26th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1669683405 NPPES
Mississippi Other 302I205607 MEDICARE ID
Mississippi MEDICAID 02629297 MEDICARE ID
Mississippi MEDICAID 00359815 MEDICARE ID

Popular Providers