Healthcare Provider Details

I. General information

NPI: 1316884216
Provider Name (Legal Business Name): VAISHNAVI AKSHAY PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SOUTHHAVEN FAMILY PRACTICE 7736 AIRWAYS BLVD
SOUTHHAVEN MS
38671
US

IV. Provider business mailing address

BAPTIST MEMORIAL DESOTO 7601 SOUTHCREST PKWY
SOUTHHAVEN MS
38671
US

V. Phone/Fax

Practice location:
  • Phone: 662-772-3700
  • Fax:
Mailing address:
  • Phone: 662-772-3700
  • Fax: 662-772-4698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: