Healthcare Provider Details

I. General information

NPI: 1720021306
Provider Name (Legal Business Name): JONATHAN CAIN ROYALTY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 W RAHN RD
DAYTON OH
45429-2219
US

IV. Provider business mailing address

33 W RAHN RD
DAYTON OH
45429-2219
US

V. Phone/Fax

Practice location:
  • Phone: 937-433-8990
  • Fax: 937-433-8691
Mailing address:
  • Phone: 937-433-8990
  • Fax: 937-433-8691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number35.090022
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number51981351205
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35090022
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number35.090022
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.090022
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: