Individual
KORY A TILLERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5901 HARPER DR NE BLDG 1, ALBUQUERQUE, NM 87109-3569
(505) 848-3730
(505) 848-3732
Mailing address
5901 HARPER DR NE BLDG 1, ALBUQUERQUE, NM 87109-3569
(505) 848-3730
(505) 848-3732
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
2024-0339
NM
207RI0200X
Infectious Disease Physician
Primary
2024-0339
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
94909261
—
NM
Enumeration date
03/28/2019
Last updated
04/24/2026
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