Contact Type. □ Office Manager □ Billing Manager □ Claims Manager □ Owner □ Doctor □ Customer Service Manager Contact Name: Phone Number: ( ) - Ext.: FAX #: ( ) - E-Mail:
Appears in 2 contracts
Samples: Credentialing Document Requirements, Provider Agreement
Contact Type. □ Office Manager □ Billing Manager □ Claims Manager □ Owner □ Doctor □ Customer Service Manager Contact Name: Phone Number: ( ) - Ext.: FAX #: ( ) - E-Mail:
Appears in 2 contracts
Samples: Provider Agreement, Credentialing Document Requirements