# RELIANT DIRECT PRIMARY CARE LLC

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

## Provider details

- **NPI number:** 1386415875
- **Authorized official:** JONATHAN K BUSHMAN DO (PRESIDENT/OWNER)
- **Authorized official phone:** (580) 599-0272

## Contact information

- **Practice address:** 822 W RANDOLPH AVE, ENID, OK 73701-3834
- **Practice address phone:** (580) 599-0272
- **Practice address fax:** (580) 603-8602
- **Mailing address:** 822 W RANDOLPH AVE, ENID, OK 73701-3834
- **Mailing address phone:** (580) 599-0272
- **Mailing address fax:** (580) 603-8602

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 01/12/2024
- **Last updated:** 07/29/2026