Tele Medicine Tele MedicineWelcome, $first_name! You can edit information in your profile.
| DOB: | $dob |
| Gender: | $sex |
| Primary Insurance: | $ins_co1 |
| Treating Dr/PCP: | $treat_dr |
We have the following packet for you to fill out!
New Patient Packet| Physician Name | Specialty | Phone | |
|---|---|---|---|
| Dr. Kendall Carll | Spine Surgery | $phys_phone | $phys_email |
| Dr. Michael Rimlawi | Spine Surgery | $phys_phone | $phys_email |
| Dr. Ceser Duclair | Pain Management | $phys_phone | $phys_email |
| Dr. Vijay Arvind | Pain Management | $phys_phone | $phys_email |
| Dr. Abdul Itani | Pain Management | $phys_phone | $phys_email |
| Dr. Kevin Williams | Orthopedic Surgery | $phys_phone | $phys_email |
| Dr. Greg Podleski | Orthopedic Surgery | $phys_phone | $phys_email |
| Dr. Robert Ippolitto | Plastic Surgery | $phys_phone | $phys_email |
| Dr. Emmanuel Ubinas | Plastic Surgery | $phys_phone | $phys_email |
| Dr. Marshall Wright | Pain Management | $phys_phone | $phys_email |
| Dr. Larry Hayes | Podiatric Surgery | $phys_phone | $phys_email |
$specialty
$phys_practice
$work_hours
$physician_svc_region
$phys_in_ins
Office Manager: $physician_off_mgr
Best Day/Time: $visit_hours
Days & Hours of Operation: $work_hours
Branch: $physician_branch
Address: $physician_address
City: $physician_city
Zip: $physician_zip
Cell: $physician_cell
Group ID: $group_id
Address2: $physician_address2
State: $physician_state
Phone: $physician_phone
Fax: $physician_fax
$specialty
$phys_practice
$work_hours
$physician_svc_region
$phys_in_ins
Office Manager: $physician_off_mgr
Best Day/Time: $visit_hours
Days & Hours of Operation: $work_hours
Branch: $physician_branch
Address: $physician_address
City: $physician_city
Zip: $physician_zip
Cell: $physician_cell
Group ID: $group_id
Address2: $physician_address2
State: $physician_state
Phone: $physician_phone
Fax: $physician_fax
$specialty
$phys_practice
$work_hours
$physician_svc_region
$phys_in_ins
Office Manager: $physician_off_mgr
Best Day/Time: $visit_hours
Days & Hours of Operation: $work_hours
Branch: $physician_branch
Address: $physician_address
City: $physician_city
Zip: $physician_zip
Cell: $physician_cell
Group ID: $group_id
Address2: $physician_address2
State: $physician_state
Phone: $physician_phone
Fax: $physician_fax
$specialty
$phys_practice
$work_hours
$physician_svc_region
$phys_in_ins
Office Manager: $physician_off_mgr
Best Day/Time: $visit_hours
Days & Hours of Operation: $work_hours
Branch: $physician_branch
Address: $physician_address
City: $physician_city
Zip: $physician_zip
Cell: $physician_cell
Group ID: $group_id
Address2: $physician_address2
State: $physician_state
Phone: $physician_phone
Fax: $physician_fax
$specialty
$phys_practice
$work_hours
$physician_svc_region
$phys_in_ins
Office Manager: $physician_off_mgr
Best Day/Time: $visit_hours
Days & Hours of Operation: $work_hours
Branch: $physician_branch
Address: $physician_address
City: $physician_city
Zip: $physician_zip
Cell: $physician_cell
Group ID: $group_id
Address2: $physician_address2
State: $physician_state
Phone: $physician_phone
Fax: $physician_fax
$specialty
$phys_practice
$work_hours
$physician_svc_region
$phys_in_ins
Office Manager: $physician_off_mgr
Best Day/Time: $visit_hours
Days & Hours of Operation: $work_hours
Branch: $physician_branch
Address: $physician_address
City: $physician_city
Zip: $physician_zip
Cell: $physician_cell
Group ID: $group_id
Address2: $physician_address2
State: $physician_state
Phone: $physician_phone
Fax: $physician_fax
$specialty
$phys_practice
$work_hours
$physician_svc_region
$phys_in_ins
Office Manager: $physician_off_mgr
Best Day/Time: $visit_hours
Days & Hours of Operation: $work_hours
Branch: $physician_branch
Address: $physician_address
City: $physician_city
Zip: $physician_zip
Cell: $physician_cell
Group ID: $group_id
Address2: $physician_address2
State: $physician_state
Phone: $physician_phone
Fax: $physician_fax
$specialty
$phys_practice
$work_hours
$physician_svc_region
$phys_in_ins
Office Manager: $physician_off_mgr
Best Day/Time: $visit_hours
Days & Hours of Operation: $work_hours
Branch: $physician_branch
Address: $physician_address
City: $physician_city
Zip: $physician_zip
Cell: $physician_cell
Group ID: $group_id
Address2: $physician_address2
State: $physician_state
Phone: $physician_phone
Fax: $physician_fax
$specialty
$phys_practice
$work_hours
$physician_svc_region
$phys_in_ins
Office Manager: $physician_off_mgr
Best Day/Time: $visit_hours
Days & Hours of Operation: $work_hours
Branch: $physician_branch
Address: $physician_address
City: $physician_city
Zip: $physician_zip
Cell: $physician_cell
Group ID: $group_id
Address2: $physician_address2
State: $physician_state
Phone: $physician_phone
Fax: $physician_fax
$specialty
$phys_practice
$work_hours
$physician_svc_region
$phys_in_ins
Office Manager: $physician_off_mgr
Best Day/Time: $visit_hours
Days & Hours of Operation: $work_hours
Branch: $physician_branch
Address: $physician_address
City: $physician_city
Zip: $physician_zip
Cell: $physician_cell
Group ID: $group_id
Address2: $physician_address2
State: $physician_state
Phone: $physician_phone
Fax: $physician_fax
$specialty
$phys_practice
$work_hours
$physician_svc_region
$phys_in_ins
Office Manager: $physician_off_mgr
Best Day/Time: $visit_hours
Days & Hours of Operation: $work_hours
Branch: $physician_branch
Address: $physician_address
City: $physician_city
Zip: $physician_zip
Cell: $physician_cell
Group ID: $group_id
Address2: $physician_address2
State: $physician_state
Phone: $physician_phone
Fax: $physician_fax
