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General NPI Number Information
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NPI Number | 1588629414
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Entity Type | Individual
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Provider Name | THOMAS LEE EARWOOD MD
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Gender | Male
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Dates
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Enumeration Date | 04/20/2006
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 1225 W 190TH ST STE 280
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City | GARDENA
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State | CA
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Zip | 90248-4305
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Country | US
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Telephone | 877-515-8113
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Fax | 877-538-2102
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Provider Business Mailing Address
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Address Line | 1320 19TH AVE NW
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City | CLINTON
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State | IA
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Zip | 52732-2752
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Country | US
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Telephone | 563-243-5633
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Fax | 563-243-9567
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | N2481
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 056431
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD41529
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License Number State | IA
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