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AVI Eyes, MD, FACE, FS CAI, FSM Musher Nazi, MD, FACE, FSCAIKENTUCKY CARDIOLOGY, Placate of Referral: Patient Name: Sex:Male Female Other SS# Date of Birth : Marital Status: Race: Ethnicity: Address:
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Obtain the Kentucky Cardiology PLLC form from the appropriate source.
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Begin by providing your personal information, including your full name, address, phone number, and email address.
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Indicate your medical background and qualifications, including your medical education, training, and certifications.
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Provide details about your work history, including any previous medical practices you have been associated with.
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Include information about your areas of specialty and expertise within the field of cardiology.
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Kentucky Cardiology PLLC is a professional limited liability company specializing in cardiology services.
The owners or managing members of Kentucky Cardiology PLLC are required to file the necessary paperwork with the state.
To fill out Kentucky Cardiology PLLC, the owners or managing members must provide information about the company's operations, financials, and management structure.
The purpose of Kentucky Cardiology PLLC is to provide specialized cardiology services to patients in the state.
Information such as the company's name, address, members, financial reports, and any changes in ownership or management must be reported.
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