# EARL J PRIMO MS OD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558502971
- **Authorized official:** DR. EARL J PRIMO O.D. (OWNER)
- **Authorized official phone:** (985) 867-8708

## Contact information

- **Practice address:** 880 N HIGHWAY 190, COVINGTON, LA 70433-5147
- **Practice address phone:** (985) 867-8708
- **Practice address fax:** (985) 867-8711
- **Mailing address:** 205 STONEWOOD DR, COVINGTON, LA 70433-5819
- **Mailing address phone:** (504) 606-1701
- **Mailing address fax:** (985) 871-9953

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | 1332-466T | LA | Yes |

## Other

- **Enumeration date:** 03/14/2009
- **Last updated:** 03/11/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1153796 | — | LA |