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Organization
PRIMARY ENT, L.L.C.
Active
Organization
PRIMARY ENT, L.L.C.
Active
Other names
Primary ENT
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN LUTHER BOONE MD (OWNER/PRESIDENT)
(612) 406-9966
Entity
Organization
Contact information
Practice address
14020 HWY 13 S STE 350, SAVAGE, MN 55378-7103
(952) 395-2500
(952) 395-2501
Mailing address
6021 NORTHWOOD RDG, BLOOMINGTON, MN 55438-1282
(612) 406-9966
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
—
NULL
207Y00000X
Otolaryngology Physician
—
—
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
—
NULL
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
06/13/2022
Last updated
11/17/2022
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