Individual
KELLY OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
2 MEDICAL PARK RD STE 300, COLUMBIA, SC 29203-6839
(803) 434-8800
(803) 434-8802
Mailing address
300 E MCBEE AVE STE 300, GREENVILLE, SC 29601-2899
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2339
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2569PA
—
SC
Enumeration date
09/20/2013
Last updated
11/17/2025
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