Apply for Collaborating Physician

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:Collaborating Physician
ID:PT-DR-MOB-08.12.24
Department:Operations
Location:N/A
Resume
* Resume:
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Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Opt-In Confirmation
By submitting this application, I consent to receive SMS updates from MainStreet Family Care at 8556485172 regarding my employment application. My information will not be shared or used for any other purposes. This application is powered by ApplicantStack on behalf of MainStreet Family Care. SMS messages will only be sent by MainStreet Family Care and are used exclusively for hiring-related communications when you have subscribed to receive SMS communications.
Attachments
Cover Letter:
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2024 Collaborating Physician
* 1. Are you a board-certified Medical Doctor?
Yes
No
* 2. Are you a board eligible Medical Doctor?
Yes
No
* 3. Do you have at least 3 years of experience as a Medical Doctor?
Yes
No
* 4. Have you ever had your credentialing status revoked by an insurance company?
Yes
No
* 5. Has your license to practice medicine ever been suspended or revoked?
Yes
No
* 6. Is your license currently in “good standing?”
Yes
No
* 7. Do you currently supervise any Nurse Practitioners?
Yes
No
* 8. If yes, how many?
* 9. When can you start?
* 10. Are you legally eligible to be employed in the United States? (Proof of identity and eligibility will be required upon employment)
Yes
No
* 11. Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation?
Yes
No
* 12. Would your schedule allow for AT LEAST one in-clinic day every four weeks?
Yes
No

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