# ELEMENTS MEDICAL GROUP OF MISSISSIPPI INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508386582
- **Authorized official:** CHERYL MAPLESDEN (SR DIRECTOR RCM)
- **Authorized official phone:** (615) 540-3708

## Contact information

- **Practice address:** 3949 HIGHWAY 43 N, BRANDON, MS 39047-7240
- **Practice address phone:** (601) 829-2500
- **Practice address fax:** (601) 829-4278
- **Mailing address:** PO BOX 671673, DALLAS, TX 75267-1673
- **Mailing address phone:** (562) 303-9718
- **Mailing address fax:** (562) 264-1219

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | 7875 | MS | Yes |
| 2084P0800X | Psychiatry Physician | — | MS | — |
| 363LF0000X | Family Nurse Practitioner | 862194 | MS | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 850823 | MS | — |

## Other

- **Enumeration date:** 06/21/2017
- **Last updated:** 06/21/2017