BEFORE YOU BEGIN:

Providers who join Soteria Healthcare must also have at least two years of practice experience. Some exceptions may apply if less than two years. Please call our Credentialing Department at (770) 455-8190 to request an application or click here to begin completing your application online and download the appropriate forms.

NOTE: When you “Print” your Application(s) and Mail Them, Please Do Not Print Front and Back Pages On Your Printer. Thank you!

Apply Today …

Providers who join Soteria must also have at least two years of practice experience. Some exceptions may apply if less than two years.

Please download and print ALL of the Soteria Healthcare Application Materials below. Once completed, please attach any necessary documentation. Then, simply “print and mail” the materials back to us (Address below) Please note, original signatures required – no copies). It’s just that easy! We look forward to serving you!

INITIAL APPLICATION MATERIALS (Please Download and Complete All)
Got Application/Membership questions? Call 770-455-8190 x 171

• The Latest Soteria_Healthcare Credentialing_Checklist …
• Application | PART 1
• Application | PART 2 …
• Application | PART 3 …
• Agreement | [Download & Sign] …
• W-9 | [Download & Sign] …
• C.V. | [Download & Sign] …
  Note: Use this Form ONLY if you DO NOT  Currently Have An Existing C.V.

RE-CREDENTIALING MATERIALS
Got Application/Membership questions? Call 770-455-8190 x 171

• Re-Cred. Checklist [Download] …
• Georgia Reappointment Application …
• Soteria Re-Cred. Appl. [Download] …
• ADDRESS CHANGE Update
• W-9 | [Download & Sign] …

MAILING ADDRESS (incl. credentialing applications):

Soteria Healthcare
4080 McGinnis Ferry Road
Building 800, Suite 801
Alpharetta, GA 30005

CONTACT:

Tel. +770-455-8190      |      Fax. +770-455-4120
Email. info@soteriahealthcare.com
URL: http://www.SoteriaHealthcare.com