Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jack Woodworth Sample II, MD

Individual provider Surgery Physician · NPI 1093393944

Jack Woodworth Sample II, MD is a Surgery Physician in Rochester, Minnesota. Licensed in Minnesota. Registered with an NPI since 2021.

Licensed in
MN
In the registry since
2021
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

200 1st St SW
Rochester, MN 55905-0001
Phone: (507) 284-2511
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 72034 (MN)
Surgery Physician Taxonomy 208600000X · Licence 31589 (MN)

Record details

NPI number1093393944
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 31, 2021
Last updated in NPPESAugust 11, 2022
Certification dateAugust 11, 2022

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