Bryan C Fagan (NPI# 1669683405, PAC ID# 4587719281) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
Nation Provider ID (NPI) | 1669683405 |
PAC ID by PECOS | 4587719281 |
Professional Enrollment ID | I20090902000000 |
Full Name | Bryan C Fagan |
Organization Legal Name | NORTH EAST ORTHOPAEDICS PA |
Address |
499 Gloster Creek Vlg G1 Tupelo MS 38801-4751 |
Phone Number | 6623776700 |
Gender | M |
Medical School | UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE |
Graduation Year | 2004 |
Primary Specialty | ORTHOPEDIC SURGERY |
Group Practice PAC ID | 4587642905 |
Number of Group Practice Members | 3 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
250004 | NORTH MISSISSIPPI MEDICAL CENTER |
250025 | GILMORE MEMORIAL HOSPITAL |
251308 | PONTOTOC HEALTH SERVICE INC CAH |
250017 | TRACE REGIONAL HOSP AND SWING BED |
Address | Phone | Organization |
---|---|---|
499 Gloster Creek Vlg, G1, Tupelo, MS 38801-4751 | 6623776700 | NORTH EAST ORTHOPAEDICS PA |
499 Gloster Creek Vlg, Suite G1, Tupelo, MS 38801-4751 | 6623772663 | ORTHOPAEDIC INSTITUTE OF NORTH MISSISSIPPI, LLC |
Organization Legal Name | NORTH EAST ORTHOPAEDICS PA |
Physicians | 3 |
Name | Specialty | Organization | Address |
---|---|---|---|
Jacob Clark Rowland | Physician Assistant | North East Orthopaedics Pa | 499 Gloster Creek Vlg, G1, Tupelo, MS 38801-4751 |
William P Pillow | Orthopedic Surgery | North East Orthopaedics Pa | 499 Gloster Creek Vlg, G1, Tupelo, MS 38801-4751 |
Street Address |
499 GLOSTER CREEK VLG G1 |
City | TUPELO |
State | MS |
Zip | 38801-4751 |
Name | Specialty | Organization | Address |
---|---|---|---|
Jon T Posey | Urology | Urology Professional Assoc | 499 Gloster Creek Vlg, Suite A1, Tupelo, MS 38801-4749 |
Michael Ted Boler Jr. | Cardiovascular Disease (cardiology) | Cardiology Associates of North Ms Pa | 499 Gloster Creek Vlg, Suite A2, Tupelo, MS 38801-4749 |
Colby Blake Ponder | Nurse Practitioner | Northeast Mental Health-mental Retardation Commission | 499 Gloster Creek Vlg, Suite A 3, Tupelo, MS 38801-4600 |
Eric Lewis | Orthopedic Surgery | Orthopaedic Institute of North Mississippi, LLC | 499 Gloster Creek Vlg, Suite G1, Tupelo, MS 38801-4751 |
Douglas L Hill | Cardiovascular Disease (cardiology) | Cardiology Associates of North Ms Pa | 499 Gloster Creek Vlg, Suite A2, Tupelo, MS 38801-4749 |
Robert C Buckley | Plastic and Reconstructive Surgery | 499 Gloster Creek Vlg, Suite D4, Tupelo, MS 38801-4711 | |
Katherine B Mcduffie | Nurse Practitioner | Cardiology Associates of North Ms Pa | 499 Gloster Creek Vlg, Suite A2, Tupelo, MS 38801-4749 |
Jonathan R Kalish | Urology | Urology Professional Assoc | 499 Gloster Creek Vlg, Suite A1, Tupelo, MS 38801-4749 |
Lauren C Holliman | Nurse Practitioner | Cardiology Associates of North Ms Pa | 499 Gloster Creek Vlg, Suite A2, Tupelo, MS 38801-4749 |
Christopher M Bell | Nurse Practitioner | Cardiology Associates of North Ms Pa | 499 Gloster Creek Vlg, Suite A2, Tupelo, MS 38801-4749 |
Find all physicians in the same address |
Name | Specialty | Organization | Address |
---|---|---|---|
Douglas Porter Anderson | Physician Assistant | 1514 Cr, 41 Magnolia Manor At Tupelo, Tupelo, MS 38801 | |
Sylvia Blanchard | Nurse Practitioner | 109 Parkgate, Tupelo, MS 38801 | |
Lloyd Perry Britt Jr. | Optometry | 2270 W Main, Suite A, Tupelo, MS 38801-3144 | |
Katie Elizabeth Richardson | Optometry | 2005 W Main St, Suite 102, Tupelo, MS 38801-3214 | |
Rickey H Bullard | Podiatry | 1902 W Main St, Tupelo, MS 38801-3228 | |
Chika Uchechukwu Iwueke | Psychiatry | 1601 W Main St, Suite D, Tupelo, MS 38801-3300 | |
James Byron Shipp | Ophthalmology | 1413 W Main St, Tupelo, MS 38801-3400 | |
Michelle M Hill | Qualified Speech Language Pathologist | Ear, Nose and Throat Physicians of North Miss., P.a | 323 N Gloster St, Tupelo, MS 38801-3623 |
Janet H Smith | Physical Therapy | Ear, Nose and Throat Physicians of North Miss., P.a | 323 N Gloster St, Tupelo, MS 38801-3623 |
Lee A Stewart | Physical Therapy | Ear, Nose and Throat Physicians of North Miss., P.a | 323 N Gloster St, Tupelo, MS 38801-3623 |
Find all physicians in zip 38801 |
City | TUPELO |
Zip Code | 38801 |
Specialty | ORTHOPEDIC SURGERY |
City + Specialty | TUPELO + ORTHOPEDIC SURGERY |
Please comment or provide details below to improve the information on Bryan C Fagan.
Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.