Blackledge, Fred

Blackledge, Fred is an individual health care provider with primary practice located at 764 Lakeland Dr , Jackson MS 39216-4617. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Blackledge, Fred can be contacted via phone (601) 981-3033.

Contact Information

Primary practice address
764 Lakeland Dr Jackson MS 39216-4617
Phone: (601) 981-3033
Fax: (601) 982-8132
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 16006 Mississippi

Profile Details

NPI number 1003890179
LBN Legal business name Blackledge, Fred
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 2nd, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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