Tillery, Kory A
Tillery, Kory A is an sole proprietor health care provider with primary practice located at 5901 Harper Dr Ne Bldg 1 , Albuquerque NM 87109-3569. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Infectious Disease, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Infectious Disease is his primary health care specialty. Tillery, Kory A can be contacted via phone (505) 848-3730.Contact Information
Primary practice address
5901 Harper Dr Ne Bldg 1
Albuquerque NM 87109-3569
Phone: (505) 848-3730
Fax: (505) 848-3732
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 2024-0339 | New Mexico |
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | 2024-0339 | New Mexico |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 2024-0339 | New Mexico |
Profile Details
| NPI number | 1548721715 |
|---|---|
| LBN Legal business name | Tillery, Kory A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 28th, 2019 |
| Last updated | Jul 7th, 2026 - about 3 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548721715 | NPPES |
| New Mexico | MEDICAID | 94909261 |
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