Check with the doctor first. I have found that not all doctors do these physicals, or drug screens, for that matter. My own doc, an internist, wouldn’t do it, so I had to ask around and make a couple of phone calls.
The pictures for your MMC will come from your TWIC. Do you have one or are in the process of getting one? If so, the CG will get the picture and fingerprints from Homeland Security.
http://www.tsa.gov/stakeholders/transportation-worker-identification-credential-twic®