Independent Medical Examination (IME) Provider Exam Sites

Document Information
  How to complete a fillable form.
Title Independent Medical Examination (IME) Provider Exam Sites

List the locations where the doctor does independent medical exams on a regular basis.

Document number F245-047-000
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Alt Language(s)
Valid dates 03/2007
Contact information Claims for Job Injuries , Treating Injured Workers
Related information

Provider Account Application - Independent Medical Examiner (IME)

Statewide Payee Registration and W-9 Form

Websites For Medical Providers

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