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Name and address of additional contracting parties or subdelegated entity If none leave blank Name Sub-delegation DOH Use Only DOH MCON ID DOH-5038 Page 1 of 4 9/11 Email Section C. Check all lines of business covered by contract Child Health Plus Medicaid Commercial Medicaid Advantage Family Health Plus Medicare HIV SNP MLTC 7. Character and Competence Review Forms enclosed forms DOH-793B Date of last DOH C C review for contractor List of curren.

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The Department of Revenue offers a toll free tax information line for Tennessee taxpayers. The number is 1-800-342-1003. If calling from Nashville or out-of-state, you may call (615) 253-0600. The Department of Revenue also offers a telecommunications device for the deaf (TDD) line at (615) 741-7398.

If you have any questions regarding the rules and regulations of the Tennessee State Board of Medical Examiners, please call (615) 532-3202 or (800) 778-4123.

Call the Tennessee Health Professional Board at 615-532-3202.

Our Three-Step Process Pre-Qualification Analysis to Ensure Eligibility. ... Simple Intake Form and State Application Preparation. ... Credentials Verification, Application Tracking and Licensing.

The transcript must be mailed directly from the educational institution to the board office located at 665 Mainstream Drive, Nashville, TN 37243 or e-mailed to Medical.Health@tn.gov.

Single Purpose License Clinical practice is limited to the following: • Engaging in the advanced study in a particular field of medicine in Tennessee; or • Teaching or demonstrating a new medical technique to medical professionals in Tennessee.

A: Yes, pursuant to TCA § 67-4-1702(a)(4)(G), there is a $400 tax levied on the privilege of engaging in the practice of medicine in Tennessee.

You have two options for filing your complaint: Centralized Complaint Intake Unit. You may phone your complaint to one of our medically trained staff by contacting Health Care Facilities, Complaint Intake Unit. ... 1-877-287-0010. Mail your Complaint. ... Division of Health Care Facilities.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232