Physician fax number directory

    • [DOC File]Home | Department of General Services

      https://info.5y1.org/physician-fax-number-directory_1_4640dd.html

      FAX 772-4936 Help Line – Toll Free 1-800-932-0211 PA SCDU – Toll Free 1-877-727-7238 PA SCDU TTY – Toll Free 1-877-676-9582. Director. Patrick Robert 783-9659. Secretary. Morales Maria 787-7945. Division of Child Support Enforcement Systems (PACSES) PO Box 8018, Harrisburg 17105-8018. FAX 705-5197 Main Number 772-1240. Director. Lyons ...

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    • [DOCX File][Name of Practice]

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      Home Draw Request Form. Fax 727-733-3973 (8am – 4pm Monday – Friday) Phone: 727-733-5036

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    • OKLAHOMA STATE DEPARTMENT OF HEALTH

      Uniform Credentialing Application. Uniform Credentialing Application. Oklahoma State Department of HealthODH Form 606. Protective Health Services Page 2 of 15Revised 11/16/2017

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    • [DOC File]Colorado Healthcare Professional Credentials Application ...

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      Claims History Contact: Fax Number: Email: Professional Insurance History: Please answer each of the following questions in full. If the answer to any question is “YES”, or requires further information, please give a full explanation of the specific details and attach to the Application.

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    • [DOC File]Physician Certification

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      Physician Signature Date. Thank you, _____ Name/Title. Return this form to: Name, address, city/state/zip code, fax number. Central Directory: 1 (800 234-1448. TTY/TTD 1(804) 771-5877 Infant & Toddler Connection of [Local System] [Address] [Address] [City], Virginia [Zip] [Phone (000) 000-0000]

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    • [DOT File]CL-18, Application for Clinical Lab License, Collection ...

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      Telephone Number ( ) Wednesday Thursday Fax Number ( ) Friday Saturday E-Mail Address. Sunday PHYSICAL PLANT 1. Location of Collection Station Store Residence Mobile Physician Office Professional Building Other, specify: 2. Are quarters shared …

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    • [DOCX File]WIC Prescriptions / Clinical Data, Infants (birth through ...

      https://info.5y1.org/physician-fax-number-directory_1_04f738.html

      Licensed health care provider must sign and date. This can include physician, physician assistant, and advanced practice certified nurse prescriber such as a nurse practitioner and certified nurse midwives who have obtained certification in order to prescribe. Contact information may …

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    • [DOC File]UNIVERSITY OF IOWA CLINICAL STAFF OFFICE

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      Name: Title: Address: City: State: Zip: Position: Phone Number: - - Fax Number: - - E-mail: Please be sure to carefully read and answer each question below, and explain any “yes” answers on page 15.

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    • [DOC File]Physician Certification

      https://info.5y1.org/physician-fax-number-directory_1_c053d4.html

      Name, address, city/state/zip code, fax number Central Directory: 1 (800 234-1448 TTY/TTD 1(804) 771-5877 Infant & Toddler Connection of [Local System] [Address]

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