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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. FRED BLACKLEDGE M.D.
NPI 1003890179
Plastic Surgery in Jackson, MS

Active since December 02, 2005
764 LAKELAND DR, JACKSON, MS 39216(601) 981-3033(601) 982-8132 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Fred Blackledge M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. FRED BLACKLEDGE M.D. (NPI 1003890179) is an individual plastic surgery provider in Jackson, Mississippi, licensed in Mississippi (16006) and active in the NPI registry since December 2005.

NPPES Registry Identity

NPI1003890179
Entity TypeIndividualMale
Primary Taxonomy208200000X
Provider Legal NameDR. FRED BLACKLEDGECredential: M.D.
Location Address764 LAKELAND DRJackson, MS 39216-4617
Mailing AddressPo Box 24023Jackson, MS 39225-4023 · (601) 366-1400 · Fax (601) 366-8167
Phone(601) 981-3033
Fax(601) 982-8132
Sole ProprietorNo
Enumeration DateDecember 2, 2005
Last NPPES UpdateJuly 13, 2026
✔ NPI 1003890179 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
License✔ Licensed in MS · 16006
Definition
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
764 LAKELAND DR, Jackson, MS 39216
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Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SARA BURWELL
Nurse Practitioner (Family)
764 LAKELAND DR
JACKSON, MS 39216
Hinds County (601) 984-5160
ARDARIAN GILLIAM-PIERRE M.D.
Family Medicine
764 LAKELAND DR, 2ND FLOOR
JACKSON, MS 39216
Hinds County (601) 984-6800
CHINEDU IFEJIAGWA MD
Student in an Organized Health Care Education/Training Program
764 LAKELAND DR
JACKSON, MS 39216
Hinds County (601) 984-6800
STANTON PAUL HEYDINGER MD
Ophthalmology
764 LAKELAND DR
JACKSON, MS 39216
Hinds County (601) 984-5020
CARRIE GRACE ALLEN MD
Family Medicine
764 LAKELAND DR
JACKSON, MS 39216
Hinds County (601) 984-6800
DR. KIARA S RICHARDSON MD
Student in an Organized Health Care Education/Training Program
764 LAKELAND DR
JACKSON, MS 39216
Hinds County (601) 984-6800
WENDY NICOLE MARINO MSN, NP-BC, CORLN
Otolaryngology
764 LAKELAND DR
JACKSON, MS 39216
Hinds County (601) 984-5516
A.TERREL WILLIAMS, MD, PLLC
Specialist
764 LAKELAND DR, STE 400
JACKSON, MS 39216
Hinds County (601) 981-1550

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fred Blackledge's NPI number?

The NPI number for Fred Blackledge is 1003890179. It was assigned to this individual provider in the NPPES registry on December 2, 2005.

Where is Fred Blackledge located?

Fred Blackledge practices at 764 Lakeland Dr, Jackson, MS 39216. The listed phone number is (601) 981-3033.

What is Fred Blackledge's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

When was this NPI record last updated?

The NPPES record for Fred Blackledge was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 31 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.