Provider Demographics
NPI:1295735181
Name:RELOJ, NOEL Z SR
Entity type:Individual
Prefix:DR
First Name:NOEL
Middle Name:Z
Last Name:RELOJ
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2009
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42702-2009
Mailing Address - Country:US
Mailing Address - Phone:270-769-6330
Mailing Address - Fax:270-766-1032
Practice Address - Street 1:551 WESTPORT RD
Practice Address - Street 2:STE C
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701
Practice Address - Country:US
Practice Address - Phone:270-769-6330
Practice Address - Fax:270-766-1032
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2018-08-23
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
KY265362084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64265366Medicaid
KY0742101Medicare PIN
KYE07390Medicare UPIN