Get the free Supervising Physician Contact Information - med ohio

PHYSICIAN ASSISTANT SUPERVISION AGREEMENT APPLICATION For Practice Outside of a Health Care Facility Only Supervising Physician Contact Information Official Mailing Address City State Contact Person Phone ZIP Code Email Practice Location Information Practice Name Address Revised7/31/17 Supervisory Agreement Terms Please Complete Questions A-D A The responsibilities to be fulfilled by the physician in supervising the physician assistant C Any limitations on the responsibilities to be fulfilled...

How to fill out supervising physician contact information

How to fill out supervising physician contact information

1. To fill out supervising physician contact information, follow these steps:
2. Start by gathering the necessary information such as the physician's name, address, phone number, and email address.
3. Open the form or document that requires the supervising physician contact information.
4. Locate the section or field specifically designated for the supervisor's contact details.
5. Enter the physician's full name in the designated field. Make sure to use the correct spelling and formatting.
6. Provide the complete address of the supervising physician. This may include the street address, city, state, and ZIP code.
7. Include the phone number of the physician in the appropriate field. Double-check for accuracy.
8. If applicable, enter the supervisor's email address in the provided space. Make sure to input a valid email address.
9. Review the entered information for any errors or missing details.
10. Once confirmed, save or submit the form, ensuring that the supervising physician contact information is included and accurate.

Who needs supervising physician contact information?

1. Supervising physician contact information is typically required by individuals or organizations that operate within regulated healthcare systems.
2. Some examples of who needs supervising physician contact information include:
3. - Medical students or residents under the supervision of a licensed physician.
4. - Physician assistants or nurse practitioners who work under the guidance of a supervising physician.
5. - Healthcare facilities or clinics that require accurate supervision records for legal and quality assurance purposes.
6. - Insurance companies or billing departments that need to verify the supervising physician's details for reimbursement or claims processing.
7. - Government regulatory bodies or licensing boards responsible for ensuring compliance and oversight in healthcare practices.

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