Healthcare Provider Details

I. General information

NPI: 1811196637
Provider Name (Legal Business Name): EMILY J MASON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY J HALEY M.D.

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 03/08/2024
Certification Date: 03/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 BAY ST STE 2
CHIPPEWA FALLS WI
54729-1810
US

IV. Provider business mailing address

1345 WALDHEIM RD
CHIPPEWA FALLS WI
54729-2012
US

V. Phone/Fax

Practice location:
  • Phone: 715-944-7470
  • Fax:
Mailing address:
  • Phone: 715-559-2384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number49707-20
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number49707-020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: