Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

John David Fagan, MD

Individual provider Urology Physician · NPI 1801827019

John David Fagan, MD is an Urology in Vicksburg, Mississippi. Graduated from University of Texas Medical Branch at Galveston in 1984, 42 years ago. Practices with Vicksburg Clinic LLC, a 27-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
42
Trained at
University of Texas Medical Branch at Galveston
Licensed in
MS
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2200 Highway 61 N
Vicksburg, MS 39183-8246
Phone: (601) 883-5940
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence 12624 (MS)

Record details

NPI number1801827019
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 5, 2006
Last updated in NPPESSeptember 10, 2020
Certification dateSeptember 10, 2020
Mailing address2080 South Frontage Rd, Suite 100, Vicksburg, MS 39180

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUROLOGY
Medical schoolUNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Graduated 1984 (42 years in practice)
Group practice Vicksburg Clinic Llc — 27 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount