# RKM PRIMARY

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

## Provider details

- **NPI number:** 1245364876
- **Authorized official:** MR. BRYAN MICHAEL BAKER (RN)
- **Authorized official phone:** (225) 683-5292

## Contact information

- **Practice address:** 6002 HANCOCK RD, GLOSTER, MS 39638-6133
- **Practice address phone:** (601) 225-7206
- **Mailing address:** 6002 HANCOCK RD, GLOSTER, MS 39638-6133
- **Mailing address phone:** (601) 225-7206

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | RN114253 | LA | Yes |

## Other

- **Enumeration date:** 03/15/2007
- **Last updated:** 08/22/2020