Organization
RKM PRIMARY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYAN MICHAEL BAKER (RN)
(225) 683-5292
Entity
Organization
Contact information
Practice address
6002 HANCOCK RD, GLOSTER, MS 39638-6133
(601) 225-7206
Mailing address
6002 HANCOCK RD, GLOSTER, MS 39638-6133
(601) 225-7206
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
RN114253
LA
Other
Enumeration date
03/15/2007
Last updated
08/22/2020
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