Fred Blackledge, M.D.

Plastic Surgery Physician · Jackson, MS

Individual Active NPI

NPI number 1003890179

Practice location

764 Lakeland Dr
Jackson, MS 39216-4617
Phone
(601) 981-3033
Fax
(601) 982-8132

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NPI record

NPI
1003890179
Entity type
Individual (Type 1)
Enumeration date
December 2, 2005
Last updated
July 13, 2026
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Plastic Surgery Physician Primary 208200000X 16006 MS

Mailing address

PO Box 24023
Jackson, MS 39225-4023
Phone
(601) 366-1400
Fax
(601) 366-8167

About Dr. Blackledge

Fred Blackledge, M.D. is a healthcare provider registered in the NPI registry with the primary taxonomy Plastic Surgery Physician (code 208200000X). The practice location is 764 Lakeland Dr, Jackson, MS 39216-4617. The NPI number 1003890179 was assigned on December 2, 2005 and the record was last updated on July 13, 2026.

Dr. Blackledge lists a license in the registry: #16006 (MS) for Plastic Surgery Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Fred Blackledge, M.D.?

The NPI number is 1003890179.

What is the phone number of Dr. Blackledge?

The phone number listed for the practice location is (601) 981-3033.

Where is Dr. Blackledge located?

764 Lakeland Dr, Jackson, MS 39216-4617.

What is the taxonomy code for Dr. Blackledge?

The primary taxonomy code is 208200000X – Plastic Surgery Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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