Provider Demographics
NPI:1962529032
Name:TOMONY, JAMES DEMETRIUS I (PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DEMETRIUS
Last Name:TOMONY
Suffix:I
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:DEMETRIUS
Other - Last Name:TOM
Other - Suffix:III
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1215 ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-1713
Mailing Address - Country:US
Mailing Address - Phone:608-259-0721
Mailing Address - Fax:
Practice Address - Street 1:301 TROY DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-1521
Practice Address - Country:US
Practice Address - Phone:608-301-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2138103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic