IndividualActive
Fred Blackledge, M.D.
NPI 1003890179 · Plastic Surgery Physician · Jackson, MS
Provider details
- NPI number
- 1003890179
- Entity type
- Individual
- Primary specialty
- Plastic Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- License
- 16006 (MS)
Practice location
764 Lakeland Dr
Jackson, MS 39216-4617
Phone: (601) 981-3033
Fax: (601) 982-8132
Mailing address
Po Box 24023
Jackson, MS 39225-4023
Registry dates
- Enumerated
- 2005-12-02
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.