Complete your profile

Once you've provided all the necessary information and your profile is complete, you may submit your application for our consideration — The screening process usually takes three working days and you will be notified about the outcomes by email.

What happens next?

Successful physicians can start applying for available vacancy immediately. However, if your application is rejected due to missing information, you will have the opportunity to update it at a later stage for consideration.

Profile Completion 30%
HOW DO I COMPLETE MY PROFILE?
Please find below a list of the sections that require your attention. Following completion, you may come back to this overview page to submit your application for consideration.
Complete your Personal details section
Date of birth, place of birth, mailing address
Provide details about your Education
Include any professional, internship and residential education
Complete your Employment history
You must explain any gaps in your employment records
Submit your Peer references
You have submitted 3 out 4 required references

Personal details

Full name Dr Talia Helena Smith
Previous/Maiden name n/a
Speciality Neurointerventional Surgery
Date of birth 02/14/1972
Place of birth Saline, MO, USA
Gender Prefer not to state
Email address talia.h.smith@organisation.com
Phone number (561) 345-789
Mobile number (123) 654-009
Residency status/Work permit US Citizen | View passport
Social Security Number · · · · · · · · · · ·
Driver's license MO 56789-321654

Permanent/mailing address

Permanent address 6080 N US 75-Central Expy 1000 #150, Dallas, TX 75206, United States
Mailing address Use permanent address

Emergency contact

Privileges

Education

Medical education

2014 - 2018
Obstetrics and gynecology
Post graduate diploma

FSU College of Medicine - Regional Campus
Orlando, FL

Upload relevant evidence (i.e. Certificate, diploma, examination license, etc.)

File types allowed: jpg, jpeg, png, pdf, doc, docx
Max size allowed: 10MB

Certifications

Board certification

Active
Royal Colleges of Physicians in England
Certificate number: 7754397474
Issue date
12/31/2012
Expiration date
12/31/2022

Board certification

Expired
Board of Medical Oncology Certification
Certificate number: 1638—663007
Issue date
12/12/2014
Expiration date
12/12/2017
Upload insurance certificate

File types allowed: jpg, jpeg, png, pdf, doc, docx
Max size allowed: 10MB

Licenses

CDS, DEA and state licenses

License type State License no. Issue date Expiration date
DEA license Kentucky KT2345/43002 12/12/2016 12/12/2017
State license Massachusetts HGY876509-TG 09/21/2021 09/21/2023
State license Tennessee KT2345/43002 09/21/2020 12/12/2021
DEA license Oklahoma 2345-43002 02/12/2021 02/12/2022
CDS license Illinois 9867400001-2K 12/12/2020 12/12/2023
State license Kentucky KT2345/43002 05/11/2022 105/11/2024
Upload license

File types allowed: jpg, jpeg, png, pdf, doc, docx
Max size allowed: 10MB

List all current and/or previous employment positions — Please include hospitals, health systems, and ambulatory surgery centers where you have ever had an afiliation (membership and/or privileges) or where you have an application in process.

PLEASE NOTE
You must explain all employment gaps in your resumé — Explain employment gaps

Locums position: Weatherby Healthcare

Nerology trainee nurse
Johns Hopkins Bayview Medical Center
Baltimore, MD 21224
Start date
02/12/2022
End date
Present
Department
Lung Cancer Surgery
Point of contact
Wilson Castro | wilson.gastro@hopkins.org | 351-348-9834

Direct employment

Nerology trainee nurse
Johns Hopkins Bayview Medical Center
Baltimore, MD 21224
Start date
12/12/2014
End date
01/15/2022
Department
Lung Cancer Surgery
Point of contact
Wilson Castro | wilson.gastro@hopkins.org | 351-348-9834

Employment gap

Marshmallow I love cheesecake bonbon. Toffee macaroon croissant macaroon sweet roll. Jelly brownie ice cream wafer sugar plum macaroon. Marzipan cake I love shortbread lollipop.

Sugar plum sugar plum pie I love gummi bears sweet roll bear claw. Jelly-o dessert cookie powder I love dessert wafer jelly-o candy. Danish ice cream dragée wafer topping topping icing chocolate chupa chups. Sugar plum sugar plum pie I love gummi bears sweet roll bear claw. Jelly-o dessert cookie powder I love dessert wafer jelly-o candy. Danish ice cream dragée wafer topping topping icing chocolate chupa chups.

Jelly brownie ice cream wafer sugar plum macaroon — Marzipan cake.

Start date
12/12/2012
End date
10/01/2014

Military service

US military
Marine Corps
Start date
10/13/2004
End date
12/03/2012
Type of discharge
Other than honorable (OTH) discharge
Military discharge
Download DD-124

Locums position: Hayes Locums

Nerology trainee nurse
Johns Hopkins Bayview Medical Center
Baltimore, MD 21224
Start date
02/12/2003
End date
01/01/2004
Department
Lung Cancer Surgery
Point of contact
Wilson Castro | wilson.gastro@hopkins.org | 351-348-9834
Upload your military discharge DD-124

File types allowed: jpg, jpeg, png, pdf, doc, docx
Max size allowed: 10MB

If Locum or private contract
Employer details
i.e Nurse
i.e Lung Cancer Surgery
Point of contact
For referencing purpose

Licensing examinations

COMLEX — Comprehensive Osteopathic Medical Licensing Examination

No COMLEX — Comprehensive Osteopathic Medical Licensing Examination — Add

Insurance

Insurance policies

Insurance provider Cover type Policy no. Issue date Expiration date
Aspen American Insurance Company Malpractice KT2345/43002 12/04/2022 12/04/2023
Molina Healthcare, Inc Type omega KT2345/43002 12/04/2021 12/04/2022
Upload insurance certificate

File types allowed: jpg, jpeg, png, pdf, doc, docx
Max size allowed: 10MB

Peer references

Please provide four professional references with whom you have had clinical contact within the last 12 months. Two of your references must be within your medical specialty.

If none is available in that time frame, please provide us with an explanation.

PLEASE NOTE
If you are just completing a residency or fellowship please list your program director as one of the references.
Co-Residents are not accepted, sorry!
TL
Prof Thomas Loveduck j.smith@university.edu 561-345-9921
Position/Profession
Assistant neurology nurse
Speciality
Otolaryngology
Insitution
Jersey City Hospital
Address
355 Grand St
Jersey City
NJ 07302
United States
JS
Dr Jonathan Smith j.smith@university.edu 561-345-9921
Position/Profession
Assistant neurology nurse
Speciality
Otolaryngology
Insitution
Saint Michael's Medical Center
Address
11 Central Avenue
Newark
NJ 07102
United States
SR
Miss Siena Rabbit siena@lab-a.net 561-345-9921
Position/Profession
Neurosurgeon
Speciality
Otolaryngology
Insitution
Saint Michael's Medical Center
Address
11 Central Avenue
Newark
NJ 07102
United States

Documents

Emails

Activities

Profile updated
10/23/2022 18:40 by applicant
Physician's email address verified
10/21/2022 10:40 by applicant
Application created
10/18/2022 18:39 by Adam Luke

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