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

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
Mailing addressPo Box 24023, Jackson, MS 39225-4023

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