Fred Blackledge in Jackson - Plastic Surgery
Fred Blackledge - NPI 1003890179
Fred Blackledge is a Plastic Surgery in Jackson, Mississippi. Fred Blackledge practices all healthcare services and medical treatments related to Plastic Surgery. The NPI Number for Fred Blackledge is 1003890179. The last update date is 2007-07-08.
Fred Blackledge's current location address is 764 Lakeland Dr, Jackson, Mississippi. You can contact this provider via phone number 6019813033 and fax number 6019828132. The mailing address for Fred Blackledge is 764 Lakeland Dr, Jackson, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Fred Blackledge |
|---|---|
| Address | 764 Lakeland Dr, Jackson, Mississippi |
| Phone Number | 6019813033 |
| Fax Number | 6019828132 |
| Sole Proprietor | X |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1003890179 |
|---|---|
| Provider Enumeration Date | 2005-12-02 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 764 Lakeland Dr |
|---|---|
| City | Jackson |
| State | Mississippi (MS) |
| Post Code | 392164617 |
| Phone Number | 6019813033 |
| Fax Number | 6019828132 |
Provider's Primary Taxonomy Detail
| Speciality | Plastic Surgery |
|---|---|
| Taxonomy | 208200000X |
| Licence No | 16006 |
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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 c |
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Post Comment/ Review Below
What is the Fred Blackledge's unique identification number?
The Fred Blackledge has been assigned the NPI (National Provider Identifier) Number 1003890179 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you provide the complete address where Fred Blackledge is physically located?
The Fred Blackledge is situated at the following address: 764 Lakeland Dr, Jackson, MS 392164617.
What is the area of specialization for Fred Blackledge, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Fred Blackledge is Plastic Surgery, and the corresponding taxonomy code that categorizes this area of expertise is 208200000X.
On what date did the Fred Blackledge receive the assignment of its 1003890179 from the Centers for Medicare & Medicaid Services?
The Fred Blackledge was issued its 1003890179 by the Centers for Medicare & Medicaid Services on 2005-12-02.
As of what date were the details related to Fred Blackledge most recently updated or revised?
The information pertaining to Fred Blackledge, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.