NPI 1003890179

Fred Blackledge, MD

Practitioner Plastic Surgery Physician Jackson, MS

Practice location

Address: 764 Lakeland Dr, Jackson, MS 39216-4617
Phone: (601) 981-3033
Fax: (601) 982-8132
Mailing address: PO Box 24023, Jackson, MS 39225-4023

Registered specialties

Plastic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208200000X Licence 16006 (MS)

Other Plastic Surgery providers in Mississippi →

Registry record

NPI: 1003890179
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Dec 2005
Record last updated: 13 Jul 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.