Provider Demographics
NPI:1093475766
Name:SIX OAKS MEDICINE LLC
Entity Type:Organization
Organization Name:SIX OAKS MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:AIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-877-4454
Mailing Address - Street 1:239 FAIRVIEW LN
Mailing Address - Street 2:
Mailing Address - City:BERRYVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22611-2489
Mailing Address - Country:US
Mailing Address - Phone:540-877-4237
Mailing Address - Fax:540-217-3400
Practice Address - Street 1:239 FAIRVIEW LN
Practice Address - Street 2:
Practice Address - City:BERRYVILLE
Practice Address - State:VA
Practice Address - Zip Code:22611-2489
Practice Address - Country:US
Practice Address - Phone:540-877-4237
Practice Address - Fax:540-217-3400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty