Tracking Details - #1204

Tracking Information
Case No: 1112
Order Date: 12/04/2025
Due Date:
Template Packet: HIPAA Authorization Packet
Scope:
Location: Academy Physical Medicine and/or Dr. Randall Smith
9140 Academy Road
Philadelphia, PA 19114
Phone: (215) 333-9999 • Fax: (215) 333-9815
Patient: Oprah Winfrey
DOB: 12/16/1989 • SSN: ***-**-7667
Academy Physical Medicine and/or Dr. Randall Smith
9140 Academy Road
Philadelphia, PA 19114
Phone: (215) 333-9999 • Fax: (215) 333-9815
Oprah Winfrey
DOB: 12/16/1989 • SSN: ***-**-7667
Requested Records
Record Status
Billing Pending
File Name Uploaded Date Uploaded By
No documents found.
Tracking Step Log
Step Due Date Remarks Publish Entered
Received Order, In Progress Yes 12/4/2025 5:47 PM
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