Provider Demographics
NPI:1003834722
Name:SAVILLE, BRIAN JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JAMES
Last Name:SAVILLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12255 DEPAUL DR
Mailing Address - Street 2:SUITE 460
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044
Mailing Address - Country:US
Mailing Address - Phone:314-770-2300
Mailing Address - Fax:314-770-1843
Practice Address - Street 1:12255 DEPAUL DR
Practice Address - Street 2:SUITE 460
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044
Practice Address - Country:US
Practice Address - Phone:314-770-2300
Practice Address - Fax:314-770-1843
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2023-05-03
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Provider Licenses
StateLicense IDTaxonomies
MO20040016592080N0001X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL$$$$$$$$$Medicaid
MO209088004Medicaid