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

Individual provider Plastic Surgery Physician · NPI 1003890179

Dr. Fred Blackledge, MD is a Plastic Surgery Physician in Jackson, Mississippi. Licensed in Mississippi. Registered with an NPI since 2005.

Licensed in
MS
In the registry since
2005
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

764 Lakeland Dr
Jackson, MS 39216-4617
Phone: (601) 981-3033
Fax: (601) 982-8132
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X · Licence 16006 (MS)

Record details

NPI number1003890179
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedDecember 2, 2005
Last updated in NPPESJuly 13, 2026

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