# PRIMARY ENT, L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Primary ENT
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386374593
- **Authorized official:** DR. JOHN LUTHER BOONE MD (OWNER/PRESIDENT)
- **Authorized official phone:** (612) 406-9966

## Contact information

- **Practice address:** 14020 HWY 13 S STE 350, SAVAGE, MN 55378-7103
- **Practice address phone:** (952) 395-2500
- **Practice address fax:** (952) 395-2501
- **Mailing address:** 6021 NORTHWOOD RDG, BLOOMINGTON, MN 55438-1282
- **Mailing address phone:** (612) 406-9966

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | — | NULL | — |
| 207Y00000X | Otolaryngology Physician | — | — | — |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | — | NULL | Yes |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/13/2022
- **Last updated:** 11/17/2022