If you are interested in participating in Humana Military’s East region network as a contracted provider, please fill in and submit the requested information. You will be contacted by a representative shortly.
Humana Military is currently not accepting requests to join the medical surgical network. Do not complete this form unless you are an Autism, Psychiatry, Behavioral Health, Doula or Lactation provider.
If you have previously submitted this form, you do not need to re-submit at this time. Only one entry per Tax ID Number (TIN/EIN) is permitted.