Dr. Fred Blackledge, M.D.
Dr. Fred Blackledge is a Plastic Surgery Physician provider (Plastic Surgery) practicing in Jackson, MS, registered in the NPPES registry with NPI 1003890179 since 2005. The credential MD stands for Doctor of Medicine.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1003890179 |
|---|---|
| Entity type | Individual (Type 1) |
| Name | Dr. Fred Blackledge |
| Credential | M.D. |
| Sex | Male |
| Practice address | 764 LAKELAND DR, Jackson, MS, 39216 |
| Phone | 6019813033 |
| Fax | 6019828132 |
| Enumeration date | 2005-12-02 |
| Last updated in NPPES | 2007-07-08 |
Taxonomy & licenses
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 208200000X | Plastic Surgery Physician | Primary | 16006 | MS |
MD — Doctor of Medicine: A physician who completed medical school (allopathic medicine), residency training, and state licensure. About the MD credential
Copy-ready billing details
Provider: Fred Blackledge, M.D. NPI: 1003890179 Taxonomy: 208200000X (Plastic Surgery Physician) Address: 764 LAKELAND DR, Jackson, MS, 39216
Other providers at this practice address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1386861649 | A.Terrel Williams, MD, Pllc | Organization | Specialist | Jackson, MS |
| 1528256781 | Ken Jones | Individual | Ophthalmology Physician | Jackson, MS |
| 1396185765 | John Browning | Individual | Emergency Medicine Physician | Jackson, MS |
| 1063840148 | Sara Burwell | Individual | Family Nurse Practitioner | Jackson, MS |
| 1104241660 | Ardarian Gilliam-Pierre | Individual | Family Medicine Physician | Jackson, MS |
| 1760921894 | University of Mississippi Medical Center | Organization | General Acute Care Hospital | Jackson, MS |
| 1124550819 | Chinedu Ifejiagwa | Individual | Student in an Organized Health Care Education/Training Program | Jackson, MS |
| 1205368982 | Ashley Alphonse | Individual | Student in an Organized Health Care Education/Training Program | Jackson, MS |
Verify this record
Cross-check NPI 1003890179 against the authoritative CMS record: view Dr. Fred Blackledge on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
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Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2007-07-08.