Healthcare Provider Details

I. General information

NPI: 1831051283
Provider Name (Legal Business Name): ANTHONY LLYOD PARKER JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 11/25/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2920 W BROAD ST STE 215
RICHMOND VA
23230-5103
US

IV. Provider business mailing address

2920 W BROAD ST STE 215
RICHMOND VA
23230-5103
US

V. Phone/Fax

Practice location:
  • Phone: 800-883-8441
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: