Oklahoma Administrative Code
Title 310 - Oklahoma State Department of Health
Chapter 2 - Procedures of the State Department of Health
Subchapter 15 - Application Forms
Section 310:2-15-2 - Uniform application for credentialing of providers
Universal Citation: OK Admin Code 310:2-15-2
Current through Vol. 41, No. 13, March 15, 2024
(a) The application described in OAC 310:002-15-2(b) is intended for use pursuant to Title 63 O.S. Supp. 1998, Section 1-106.2.
(b) The uniform application for credentialing of providers requests the following:
(1)
personal information;
(2)
education, including medical, dental and professional schools;
(3) training, including internships,
residencies, fellowships and preceptorships;
(4) professional licenses;
(5) certifications and
registrations;
(6) academic
appointments;
(7) health care
affiliations;
(8) other
professional work history;
(9)
current professional practice;
(10)
office billing information;
(11)
attestation;
(12) copies of
required documents; and
(13) any
additional information needed to answer all questions fully.
Added at 16 Ok Reg 901, eff 1-5-99 (emergency); Added at 16 Ok Reg 1389, eff 5-27-99; Amended at 17 Ok Reg 687, eff 12-16-99 (emergency); Amended at 17 Ok Reg 2034, eff 6-12-00
Disclaimer: These regulations may not be the most recent version. Oklahoma may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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