MEDICARE: MSK GROUP, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1295440782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MSK GROUP, PC

Provider Business Mailing Address
First Line	:	6077 PRIMACY PKWY STE 140
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38119-5754
Country	:	US
Telephone Number	:	901-641-3000
Fax Number	:	901-259-1698

Provider Business Practice Location Address
First Line	:	5150 AIRLINE RD STE 400
Second Line	:
City	:	ARLINGTON
State	:	TN
Zip	:	38002-8008
Country	:	US
Telephone Number	:	901-641-3000
Fax Number	:	901-373-0804

Authorized Official
Title or Position	:	CFO
Name	:	CHRIS RUSCITTO
Credential	:
Telephone Number	:	901-725-8347

Provider Enumeration Date	:	01/18/2023
Last Update Date	:	03/30/2023

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