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Physician Extender Privileges

West Tennessee Healthcare recognizes the important role of the physician extender in the care of our patients. That is why we welcome you as the physician extender for your physician.

The application form is provided through the link below. Please complete the items on this application so that we can process your privileges. Once you have completed all the necessary information, you will submit it and it will be e-mailed to the appropriate resource person.

Notice: If you are currently under contracted service with any General Hospital Distric entity, STOP this process and call Centralized Credentialing at 731-541-4144.

Click here for the Physican Extender Application.

If you are NOT a current West Tennessee Healthcare employee, you will need to:

1. Complete the Physician Extender Application; and

2. Complete a background check by clicking here and following the directions

Changing Your Information:

If you are currently enrolled as a Physician Extender and need to make changes to your information, please complete this form by clicking here. Physician Extenders that need to update/change information about their clinic, primary physician, email address, or name change would fill out the neccesary fields and email to PE-HR@wth.org


West Tennessee Healthcare  |  620 Skyline Drive, Jackson, TN 38301  |  731-541-5000
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