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6350 E. 2nd Street, Casper, WY 82609 Medical Records Phone: 3072324068 Medical Record Fax: 3072150900AUTHORIZATION FOR DISCLOSURE OF HEALTH INFORMATION Please note that any missing information/blanks
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Summit Medical Center 6350 is a form used to report certain payments made by medical providers to physicians or other healthcare professionals.
Medical providers are required to file summit medical center 6350 if they make payments to physicians or healthcare professionals.
Summit Medical Center 6350 can be filled out electronically or on paper. It requires information about the medical provider, the recipient of the payment, and the payment amount.
The purpose of summit medical center 6350 is to report payments made by medical providers to physicians or other healthcare professionals for transparency and compliance purposes.
Information that must be reported on summit medical center 6350 includes the name and address of the medical provider, the recipient of the payment, the payment amount, and the nature of the payment.
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