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Credentialing
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Application Form

To initiate the process of applying for a locum tenens position, please complete the forms indicated below and send to our office.
Physician Application
  
Physician Checklist

You first need Adobe Reader.
Free downloaded here.

Then, download the file:

Locum tenens physician credentialing form

Print the form, fill in the necessary fields, and fax to:

(407) 703-7024

You first need Adobe Reader.
Free downloaded here.

Then, download the file:

Locum tenens physician credentialing form

Print the form, fill in the necessary fields, and fax to:

(407) 703-7024

In addition to your application, please download, fill out, and submit
an Locum Physicians finds temporary staffing positions for doctors in Florida and all over the USA. IRS W-9 form for tax purposes.

Ways to Send Your Documents

  • Facsimile
  • E-Mail
  • U.S. Mail

Please submit all completed documents at the same time along with your dates of availability. Locum Physicians will personally market your talents.

Send To:

Locum Physicians, LLC
1631 Rocks Springs Rd, Ste. #120
Apopka, FL 32712
Phone: (407) 814-4404
FAX: (407) 703-7024
info@locum-physicians.com

How it Works
Once your paperwork has been received, a Locum Physicians processor will thoroughly review them, ensuring all of the information is sufficient, and expedite the approval. If anything is missing or incomplete, you will be notified immediately.

Contact Us
The beauty behind working with Locum Physicians is the personal attention you'll receive. If you have any questions about the application form, the credentialing process, IRS W-9, how to obtain a locum tenens position, or for answers to general questions, please contact Locum Physicians, LLC today at (407) 814-4404.

407-814-4404