Individual
MR. JAIYANTH THAYABARAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7736 AIRWAYS BLVD, SOUTHAVEN, MS 38671
(662) 772-3700
Mailing address
7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671
(662) 772-3700
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/07/2025
Last updated
08/10/2025
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