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
Phone: (662) 377-2663
Fax: (662) 377-6706
Website:
Health care specialties
| Specialty | Code | License # | 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 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669683405 | NPPES |
| Mississippi | Other | 302I205607 | MEDICARE ID |
| Mississippi | MEDICAID | 02629297 | MEDICARE ID |
| Mississippi | MEDICAID | 00359815 | MEDICARE ID |
Popular Providers
-
Pillow, William Parks
499 Gloster Creek Vlg Suite G1, Tupelo MS 38801-4600 -
Southworth, Stephen Robert
499 Gloster Creek Vlg Ste G1 , Tupelo MS 38801-4751 -
Phillips, Clyde Bennett
1464 Medical Park Cir , Tupelo MS 38801-6595 -
Massey, F. Mitchell
808 Garfield St , Tupelo MS 38801-5749 -
Thorderson, Nels Wallace
499 S Gloster St Ste G1 , Tupelo MS 38801-5539 -
Mathis, Taylor Phillips
1211 S Gloster St Suite A, Tupelo MS 38801 -
Van Osten, George Karl
4381 South Eason Blvd., Suite 303 North Mississippi Sports Medicine And Orthopaedic Clini, Tupelo MS 38801 -
Rainey, Richard D.
1211 South Gloster, Suite A , Tupelo MS 38801