MEDICARE: THOMAS LEE EARWOOD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	N2481	TX
2	2084P0800X	Psychiatry Physician	056431	GA
3	2084P0800X	Psychiatry Physician	MD41529	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	056431	OTHER	GA	LICENSE
2	MD41529	OTHER	IA	LICENSE

General Provider Information

NPI Number	:	1588629414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS LEE EARWOOD MD

Provider Business Mailing Address
First Line	:	1320 19TH AVE NW
Second Line	:
City	:	CLINTON
State	:	IA
Zip	:	52732-2752
Country	:	US
Telephone Number	:	563-243-5633
Fax Number	:	563-243-9567

Provider Business Practice Location Address
First Line	:	1225 W 190TH ST STE 280
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90248-4305
Country	:	US
Telephone Number	:	877-515-8113
Fax Number	:	877-538-2102

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	04/09/2025

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Directions to “ THOMAS LEE EARWOOD MD” Practice Location

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