Physician Credentialing
Thank you for your interest in applying to the Medical Staff at Banner Ironwood Medical Center. Our goal is to provide physicians with an ideal environment to practice medicine that is efficient, effective, safe and healing.
Applications for medical staff membership and privileges at Banner Ironwood Medical Center, along with supplementary forms and documents, are available online at the links below.
The Application Process for Banner Ironwood Medical Center
The first step in applying for privileges is to submit the Request for Initial Application form. Once the request is received by the Banner Health Credentialing Verification Organization, you will receive a more detailed application to complete.
After submitting the initial application request form, please complete, sign and return the following documents to:
Banner Ironwood Medical Center
Attn: Medical Staff Services
37000 N. Gantzel Road
San Tan Valley, AZ 85140
- Department Rules and Regulations/Delineation of Privileges Forms
- Application Invoice
- Application Invoice - Telemedicine
- Clinical Competency Peer Reference Form
- Release of Information
- CPOE EMR Training Request Form
- Autofax Form
Minimum Qualifications
The Medical Staff Bylaws describe minimum qualifications for membership. If, upon review of your initial application, it is determined you do not meet the minimum qualifications for membership and privileges, your application will not be processed.
For Pediatrics, applications are currently open for general pediatricians and the following pediatric sub specialists: Cardiology, Ophthalmology, Neurology and Pulmonology.
Please note: Banner Ironwood Medical Center requires that board certification be obtained within five years of completion of training or sooner as required by the department, or within three years of expiration of original board certification or recertification.
Please contact Medical Staff Services at (480) 394-4066 or the Banner Health CVO at (480) 684-5050 with questions.
