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NPI Code Detail

MEDICARE: MSK GROUP, PC

MEDICARE: MSK GROUP, PC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13371161OTHERTNGROUP MEDICARE PTAN

General Provider Information

NPI Number : 1942397534
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 : 901-259-1673
Fax Number : 901-259-7637
Provider Business Practice Location Address
First Line : 2100 EXETER RD STE 200
Second Line :
City : GERMANTOWN
State : TN
Zip : 38138-3966
Country : US
Telephone Number : 901-641-3000
Fax Number : 901-373-0804
Authorized Official
Title or Position : CO-CFO
Name : MR. CHRIS RUSCITTO
Credential :
Telephone Number : 901-641-3000
Provider Enumeration Date : 10/06/2006
Last Update Date : 03/02/2023

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