FAKE AGENT CALLS
The Board Staff has received several phone calls from multiple licensees stating that someone is calling pretending to be an agent of the Medical Board and trying to obtain personal information. These calls are scams. Information regarding your licensure number, issue date, expiration date, and address of record is available on the Board’s website. Your NPI number is also available on the Internet. The Board would not contact you by phone to obtain your personal information. We would contact you to set up a time that you can contact us and give you a valid call back number or schedule an in person meeting. The Board is located in Atlanta, GA and all phone numbers from the Board will have Atlanta area codes. (404, 470, 678 or 770) If you receive a call like this please do not give any personal information and disconnect the call. If you need any additional information, please contact Jonathan McGehee, Director of Investigations at firstname.lastname@example.org.
For questions about renewing your active Physician license, contact us at email@example.com or at 404-656-3913.
Application and Forms for Initial Physician Licensure
When you apply, there are additional documents needed to complete your application. In order to ensure a smooth process send these documents to the Board in a single envelope (instructions). The packet you send should include your printed application (if you apply online, print the PDF application you received).
Checklist for Initial Physician Application
Initial Physician License Application
FORM A - Certificate of Postgraduate Training
FORM B - Reference Form
FORM D - Affidavit of Applicant
FORM D2 - Affidavit for Medical Board License
FORM E - Mandatory Malpractice Questionnaire
FORM G - Specific Power of Attorney
Other Physician Forms and Information
For questions about your pending application for Physician licensure (Initial or Reinstatement), if your last name begins with the alphabetic character:
A to D
E to K
L to P
Q to Z