# THOMAS R. BLACKLEDGE, JR., MD, PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Medical Center of Magee
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376861757
- **Authorized official:** THOMAS R. BLACKLEDGE JR. M.D. (MD/OWNER)
- **Authorized official phone:** (601) 849-1918

## Contact information

- **Practice address:** 800 3RD ST SW, MAGEE, MS 39111-3951
- **Practice address phone:** (601) 849-1918
- **Practice address fax:** (601) 849-1908
- **Mailing address:** PO BOX 748, MAGEE, MS 39111-0748
- **Mailing address phone:** (601) 849-1918
- **Mailing address fax:** (601) 849-1908

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 14559 | MS | Yes |

## Other

- **Enumeration date:** 05/11/2010
- **Last updated:** 05/11/2010