Healthcare Provider Details

I. General information

NPI: 1942254677
Provider Name (Legal Business Name): MADONNA MORGAN BLAIR AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MADONN NICOLE MORGAN AU.D.

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 CORLEY MILL RD
LEXINGTON SC
29072-7600
US

IV. Provider business mailing address

300 E MCBEE AVE FL 4
GREENVILLE SC
29601-2842
US

V. Phone/Fax

Practice location:
  • Phone: 803-256-2483
  • Fax: 803-779-4624
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number3890
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberA-0377
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: