Provider Demographics
NPI:1124097787
Name:TILLERY, APRIL MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:APRIL
Middle Name:MICHELLE
Last Name:TILLERY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17510
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41017-0510
Mailing Address - Country:US
Mailing Address - Phone:513-891-4510
Mailing Address - Fax:513-793-1032
Practice Address - Street 1:7370 TURFWAY RD
Practice Address - Street 2:SUITE 250
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-4895
Practice Address - Country:US
Practice Address - Phone:859-341-5550
Practice Address - Fax:859-344-3782
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2015-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY34720207VG0400X
OH35-073445207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH160051009OtherRAILROAD MEDICARE
OH2207749Medicaid
KY64016421Medicaid
OH2207749Medicaid
OH160051009OtherRAILROAD MEDICARE