MEDICARE: JOVAN PARKER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1679418511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOVAN PARKER

Provider Business Mailing Address
First Line	:	105 MARVIN WAYNE CIR
Second Line	:
City	:	TONEY
State	:	AL
Zip	:	35773-8888
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 SPENRYN DR
Second Line	:
City	:	MADISON
State	:	AL
Zip	:	35758-1890
Country	:	US
Telephone Number	:	256-772-4400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

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Directions to “ JOVAN PARKER ” Practice Location

Language	Start Address	Practice Location

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