Healthcare Provider Details

I. General information

NPI: 1801887625
Provider Name (Legal Business Name): EXIGENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2310 WADE HAMPTON BLVD
GREENVILLE SC
29615-1043
US

IV. Provider business mailing address

2310 WADE HAMPTON BLVD
GREENVILLE SC
29615-1043
US

V. Phone/Fax

Practice location:
  • Phone: 864-292-5915
  • Fax: 864-244-7734
Mailing address:
  • Phone: 864-292-5915
  • Fax: 864-244-7734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number17379
License Number StateSC

VIII. Authorized Official

Name: DR. LYNN M.S. OWENS
Title or Position: M.D.
Credential: M.D.
Phone: 864-292-5915